RESEARCH - Thumb base involvement in symptomatic hand OA is associated with more pain and functional disability

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Ann Rheum Dis. Published Online First: 6 April 2009.

doi:10.1136/ard.2008.104562

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Concise Report

Thumb base involvement in symptomatic hand osteoarthritis is

associated with more pain and functional disability

Bijsterbosch 1*, Willemien Visser 1, Herman M Kroon 1, Tanja

Stamm 2, Ingrid Meulenbelt 1, Tom W J Huizinga 1 and Margreet

Kloppenburg 1

1 Leiden University Medical Centre, Netherlands

2 Medical University of Vienna, Austria

Abstract

Objective: To assess the impact of different subsets of symptomatic

hand osteoarthritis (OA) on pain and disability.

Methods: From 308 hand OA patients a group with CMCJ symptoms only

(group I, n=20) was identified as well as groups with symptoms at the

interphalangeal joints (IPJs) only (group II, n=138), and symptoms at

both sites (group III, n=150). Hand pain and function, assessed with

the AUSCAN, were compared between groups using linear mixed models.

Radiological OA was assessed using the Kellgren-Lawrence grading

scale.

Results: Mean (SD) AUSCAN scores for group I, II and III were 23.1

(11.7), 18.3 (11.9) and 26.4 (12.5), respectively. After adjustment

for age, gender, BMI, family effects and number of symptomatic hand

joints, significant differences in AUSCAN scores of 7.4 (95% CI

1.8-13.0) between group I and II, and 5.7 (95% CI 2.7-8.6) between

group II and III were found. AUSCAN scores were 5.8 (95% CI 3.1-8.6)

higher for patients with versus patients without CMCJ symptoms.

Kellgren-Lawrence scores did not differ between groups.

Conclusion: In symptomatic hand OA, CMCJ OA contributes more to pain

and disability than IPJ OA. Hence, treatment of CMCJ OA should be

emphasized, even if it coincides with IPJ OA.

http://ard.bmj.com/cgi/content/abstract/ard.2008.104562v1?papetoc

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