Joint-specific prevalence of osteoarthritis of the hand.
PURPOSE: To quantify the prevalence of radiographic hand osteoarthritis (OA) among a group of community-dwelling individuals. Joint-specific prevalence rates/100 of radiographic OA of the hand were quantified and reported by age, gender, and dominant hand. METHODS: Data from a community-based, longitudinal study designed to follow the natural history of OA were used. Participants were ambulatory men and women, ages 40 years and older, with and without radiographic hand OA (N = 3327). Bilateral hand OA was examined at three joints: second distal interphalangeal joints (DIP), third proximal interphalangeal joints (PIP), and first carpometacarpal joint of the thumb (CMC). The ordinal scale of Kellgren and Lawrence (0-4) was used to determine OA status (grades 2+). RESULTS: Radiographic hand OA status was determined for all persons in the study group comprised of 2302 women (69%) and 1025 men (31%). The sample sizes for the age groups (years) were 532 (40-49), 905 (50-59), 998 (60-69), 749 (70-79), and 143 (80+). Overall, the DIP joint demonstrated the highest OA prevalence, while the PIP joint showed the lowest prevalence. Joint-specific hand OA prevalence rates for second DIP, third PIP, and first CMC were 35%, 18%, and 21%, respectively. Expectedly, hand OA prevalence for all joints increased with age. With exceptions, women demonstrated higher hand OA prevalence rates for the three sites examined. However, among men aged 40-49, the second DIP joint OA rate was higher (13%) compared with women (8%). Additionally, men in that age group demonstrated an elevated first CMC joint OA rate (9%) compared with women (5%). Gender-specific hand dominance analyses demonstrated that the majority of individuals with unilateral second DIP or third PIP OA presented in their dominant hand. However, among those with unilateral first CMC OA, both genders displayed a tendency to present in their nondominant hand. CONCLUSION: These findings suggest the need for further investigation of the role gender can play in the development of hand OA in populations under 60 years of age. Additional epidemiological studies addressing hand OA will serve to bridge the gap between the current levels of knowledge about the knee and the hand. The disease burden of hand OA affects a large percentage of the population. Research efforts that more exhaustively characterize the prevalence of hand OA may contribute toward interventions that, ultimately, impact a rapidly growing segment of our population. (+info)
Validity of self-report measures of pain and disability for persons who have undergone arthroplasty for osteoarthritis of the carpometacarpal joint of the hand.
OBJECTIVE: To establish the validity of three self-report scales used to measure function following arthroplasty for osteoarthritis (OA) of the carpometacarpal joint. METHOD: Persons with OA of the carpometacarpal joint (n=122) were assessed on one occasion 9-117 months following tendon interposition arthroplasty. They completed three self-report measures of hand/upper limb disability: the Australian/Canadian Osteoarthritis Hand Index (AUSCAN), the Patient-Rated Wrist Hand Evaluation (PRWHE), and the Disabilities of Arm, Shoulder and Hand (DASH). They also completed the Short Form 36 (SF-36) and performed tests of strength, range of motion (ROM), and dexterity. Factor analysis and correlations were used to determine the association among the scales and subscales considered to measure similar constructs (e.g., pain and physical disability). Correlations between the scales and measures of impairment were also conducted to examine construct validity of the disability measures. t-Tests evaluated the hypotheses that subjects with isolated hand OA would have lower scores than those with additional joint involvement. RESULTS: All three scales or their subscales loaded on one factor. Convergent validity of the disability measures was demonstrated by high correlations between similar subscales (r>0.75), and divergent validity by a lack of correlation between the measures and self-report hand appearance. As expected, correlations between disability and strength, dexterity, or a global measure of ROM were higher than with ROM of individual joints. The AUSCAN and the DASH were better able to discriminate those with localized hand OA from those with involvement of other joints. CONCLUSIONS: The AUSCAN, PRWHE, and DASH are valid assessments of pain and/or disability of hand OA, and provide information distinct from impairment measures. (+info)
Do metabolic factors add to the effect of overweight on hand osteoarthritis? The Rotterdam Study.
BACKGROUND: As hand joints are non-weight bearing, the association between overweight and hand osteoarthritis (HOA) is critical to understanding how overweight may associate with osteoarthritis (OA) apart from axial load. Overweight might be associated with the occurrence of OA through other metabolic factors. AIM: To evaluate the role of overweight in HOA, cross-sectional data of a population-based study were used (> or =55 years, n = 3585). The role of diabetes, hypertension and total cholesterol:high-density lipoprotein (HDL)-cholesterol ratio on HOA, and whether they play an intermediate role in the association of overweight/HOA was investigated. Furthermore, the prevalence of HOA in the concurrent presence of overweight and other metabolic factors was evaluated. RESULTS: Independently of other metabolic factors, overweight (body mass index (BMI) >27.4 kg/m(2)) showed a significant association with HOA (OR 1.4, 95% CI 1.2 to 1.7). The association between diabetes and HOA was only present in people aged 55-62 years (OR 1.9, 95% CI 1.0 to 3.8), but was absent in the total population or in other age groups. The association of hypertension with HOA was weak, and disappeared after adjustment for BMI. The total/HDL cholesterol ratio showed no significant association with HOA. The concurrent presence of overweight, diabetes and hypertension resulted in an even higher prevalence of HOA (OR 2.3, 95% CI 1.3 to 3.9) compared with subjects with none of these characteristics; this prevalence increased further in the younger age group (OR 3.2, 95% CI 1.1 to 8.8). CONCLUSION: No intermediate effect of metabolic factors on the association of overweight with HOA was found. An increase in the prevalence of HOA, however, seems to be present when overweight occurs together with hypertension and diabetes especially at a relatively young age. (+info)
Work-related bilateral osteoarthritis of the first carpometacarpal joints.
BACKGROUND: A 44-year-old industrial worker produced panels for folding doors for 9 years. During this period, he developed osteoarthritis (OA) of both first carpometacarpal joints. Surgery was performed without improvement. METHODS: Clinical examination, demonstration and recording of work conditions, with photos and videos. The literature concerning first carpometacarpal OA was reviewed using PubMed. RESULTS: The observation of work conditions demonstrated unusual forceful and repetitive ulnar flexion of both first fingers. No competing causes of OA could be identified. CONCLUSION: This patient had specific and intense work-related strain of both first carpometacarpal joints. A good temporal relation between work exposure and disease development was demonstrated and it appears likely that the OA was caused by work. However, there is very limited epidemiological evidence relating first carpometacarpal OA to work exposure. (+info)
Second generation GUEPAR total arthroplasty of the thumb basal joint: 50 months follow-up in 84 cases.
Spectrum of normal and pathologic findings in the region of the first extensor compartment of the wrist: sonographic findings and correlations with dissections.
OBJECTIVE: The purpose of this presentation is to review pathologic conditions that lead to pain at the radial aspect of the distal radius and to address anatomic variations of the first extensor compartment that exist and may have diagnostic and therapeutic implications. METHODS: Our presentation is based on a review of cases from teaching files and observations made in anatomic specimens. RESULTS: The discussed conditions include de Quervain tenosynovitis, intersection syndrome, and Wartenberg syndrome. Sonographic diagnosis of these conditions is addressed, and correlations are provided with anatomic specimens. CONCLUSIONS: Sonography is able to depict and differentiate between these conditions. (+info)
Injectable hyaluronan for the treatment of carpometacarpal osteoarthritis: open label pilot trial.