Abstract
Objectives: To investigate the prevalence and pattern of osteoarthritis (OA) of the hand joints in patients presenting with hand symptoms and also to find out whether knee osteoarthritis has an association with hand osteoarthritis.
Methods: This study included patients who presented with hand symptoms of arthritis in Pain clinic and Medicine out-patient department of Uttar Pradesh University of Medical Sciences, Saifai, Etawah. We also looked for hand symptoms in those patients who were established cases of knee OA.
Hand osteoarthritis was diagnosed using European League Against Rheumatism (EULAR) Recommend-ations which includes plain radiograph of hand and clinical examination. For supporting the diagnosis we did routine blood tests. For studying the pattern of hand osteoarthritis other relevant data including age, sex, occupation, handedness and body mass index (BMI) were sought for.
Results: Hand OA is a heterogeneous, age- and gender-dependent disorder, occurring more frequently in women over 50 years of age. Of the total patients (n=200) investigated 29% of the patients had hand symptoms. Of all patients only 20% were confirmed as cases of hand OA by EULAR criteria. 33% of the knee OA patients also had hand OA irrespective of their hand symptoms. A history of heavy manual labour or a repetitive use of the hand was shown to have higher incidence. Other variables such as BMI and handedness may also play a role.
Conclusions: Elderly age, female sex, high BMI and increasing usage of hand showed an increased development of hand OA. The presence of knee OA at baseline may predict an increased risk of hand OA.
References
- Elliott AM, Smith BH, Penny KI, Smith WC, Chambers WA. The epidemiology of chronic pain in the community. Lancet 1999;9:1248–52.
- Wilder-Smith OH, Mohrle JJ, Dolin PJ, Martin NC. The management of pain in Switzerland: a comparative survey of Swiss medical specialists treating chronic pain. Eur J Pain 2001;5:285–98.
- Palmer KT. Regional musculoskeletal conditions: pain in the forearm, wrist and hand. Best Pract Res Clin Rheumatol 2003;17:113–35.
- Palmer KT, Syddall H, Cooper C, Coggon D. Smoking and musculoskeletal disorders: findings from a British national survey. Ann Rheum Dis 2003;62:33–6.
- Urwin M, Symmons D, Allison T, Brammah T, Busby H, Roxby M, et al. Estimating the burden of musculoskeletal disorders in the community: the compare-ative prevalence of symptoms at different anatomical sites, and the relation to social deprivation. Ann Rheum Dis 1998;57: 649–55.
- Eberhardt KB, Fex E. Functional impairment and disability in early rheumatoid arthritis—development over 5 years. J Rheumatol 1995;22:1037–42.
- Dellhag B, Bjelle A. A five-year followup of hand function and activities of daily living in rheumatoid arthritis patients. Arthritis Care Res 1999;12:33–41.
- Dellhag B, Hosseini N, Bremell T, Ingvarsson PE. Disturbed grip function in women with rheumatoid arthritis. J Rheumatol 2001;28:2624–33.
- Kessler S, Dieppe P, Fuchs J, Stuermer T, Guenther KP. Assessing the prevalence of hand osteoarthritis in epidemiological stu-dies. The reliability of a radiological hand scale. Ann Rheum Dis 2000;59:289–92.
- Kellgren JH, Lawrence JS. Epidemiology of chronic rheumatism. Philadelphia: FA Davis, 1963.
- Kallman DA, Wigley FM, Scott WW Jr, Hochberg MC, Tobin JD. New radiog-raphic grading scales for osteoarthritis of the hand. Reliability for determining prevalence and progression. Arthritis Rheum 1989;32:1584–91.
- Altman RD, Hochberg M, Murphy W, Wolfe F, Lequesne M. Atlas of individual radiographic features in osteoarthritis. Ost-eoarthritis Cartilage 1995;3(Suppl):3–70.
- Verbruggen G, Veys EM. Numerical scoring systems for the anatomic evolution of osteoarthritis of the finger joints. Arthritis Rheum 1996;39:308–20.
- Verbruggen G, Veys EM. Erosive and non-erosive hand osteoarthritis. Use and limitations of two scoring systems. Osteo-arthritis Cartilage 2000;8(Suppl): S45–55.
- Spector T D, Cooper C. Radiographic assessment of osteoarthritis: Whither, Kellgren and Lawrence? Osteoarthritis and Cartilage 1993 (in press).
- Altman R, Alarcon G, Appelrouth D, et al. The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hand. Arthritis Rheum 1990; 33: 1601-10.
- Kellgren J H, Lawrence J S. Radiological assessment of osteoarthritis. Ann Rheum Dis 1957; 16: 494-501.
- Hart DJ, Spector TD. The relationship of obesity, fat distribution and osteoarthritis in women in the general population: the Chinford study. J Rheumatol 1993; 20: 331-5.
- Kallman D A, Wigley F M, Scott W W, Hochberg M C, Tobin J D. New radiogr-aphic grading scales for osteoarthritis of the hand. Arthritis Rheum 1989;32:1584-91.
- Livshits G, Kalichman L, Cohen Z, Kobyl-iansky E. Mode of inheritance of hand osteoarthritis in ethnically homogeneous pedigrees. Hum Biol 2002;74:849–60.
- Onat A, Sansoy V, Uysal O. Waist circumference and waist-tohip ratio in Turkish adults: interrelation with other risk factors and association with cardiovascular disease. Int J Cardiol 1999;70:43–50.
- Empana JP, Ducimetiere P, Charles MA, Jouven X. Sagittal abdominal diameter and risk of sudden death in asymptomatic middle-aged men: the Paris Prospective Study I. Circulation 2004;110:2781–5.
Corresponding Author
Dr Manish Gupta
Assistant Professor, Dept. of General Medicine,
UPUMS, Saifai, Etawah
DOI: https://dx.doi.org/10.18535/jmscr/v5i9.169
