RESEARCH - Progression of hand OA over two years: a clinical and radiological follow-up study

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Ann Rheum Dis. Published Online First: 26 August 2008.

doi:10.1136/ard.2008.087981

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Extended Report

Progression of hand osteoarthritis over two years: a clinical and

radiological follow-up study

Stella Botha-Scheepers 1, Naghmeh Riyazi 1, Iain Watt 1, Frits R

Rosendaal 1, Eline Slagboom 1, Bellamy 2, Ferdinand C

Breedveld 1 and Margreet Kloppenburg 1*

1 Leiden University Medical Center, Netherlands

2 Centre of National Research on Disability and Rehabilitation

Medicine, University of Queensland, Australia

Abstract

Objectives: To investigate the course of hand osteoarthritis (OA) over

two years by currently available outcome measures.

Methods: 189 participants of the GARP (Genetics, ARthrosis and

Progression) study with hand OA were followed for two years.

Self-reported hand pain and functional limitations were assessed with

the Australian / Canadian Osteoarthritis Hand Index (AUSCAN LK 3.0).

Pain intensity upon lateral pressure in the interphalangeal and thumb

base joints was graded on a four-point scale. Osteophytes (0-3) and

joint space narrowing (JSN) (0-3) was scored at baseline and after two

years in interphalangeal and thumb base joints. Standardised response

means (SRM) were calculated.

Results: 172 (91%) patients completed the two-year follow-up (mean age

60.5 years, 78.5 % women). Statistically significant increases in

self-reported pain and function scores, in pain intensity scores as

well as in osteophyte and JSN total scores were seen over two years.

SRMs were 0.25, 0.23, 0.67, 0.34 and 0.35 respectively for

self-reported pain and function scores, pain intensity scores,

osteophyte and JSN total scores. Radiological progression was not

associated with changes in self-reported pain and function. Women in

an early post-menopausal stage were especially at risk to progress

radiologically.

Conclusions Currently available outcome measures were able to assess

progression over the relatively short time period of two years.

Radiographic outcomes were more responsive than self-reported

outcomes. Pain intensity upon lateral pressure seems to be a

responsive measure but need validation.

http://ard.bmj.com/cgi/content/abstract/ard.2008.087981v1?papetoc

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