Interphalangeal Joint Sonography of Symptomatic Hand Osteoarthritis: Clinical and Functional Correlation

Hand surgeons frequently treat osteoarthritis of the interphalangeal (IP) and metacarpophalangeal (MCP) joints. Age, female gender, occupation, genetics, biomechanics, obesity, and joint laxity have been implicated in the progression of disease. Physical examination and standard three-view imaging of the hand aid in initial work up. Many conservative treatments exist, including physical therapy, splinting, anti-inflammatories, and injection of corticosteroid or hyaluronic acid. With the failure of conservative therapies, surgical management is dictated by the particular joint in question. The distal interphalangeal (DIP) joints of fingers and IP joint of the thumb are more commonly treated by arthrodesis, whereas proximal interphalangeal (PIP) joints are treated with arthroplasty. Likewise, MCP joints of the fingers are typically managed with arthroplasty. The thumb MCP joint is more commonly fused. This review contains 7 figures, 4 tables, and 54 references. Keywords: hand osteoarthritis, interphalangeal joint, metacarpophalangeal joint, anatomy, arthroplasty, silicone, arthrodesis, biomechanics, outcomes

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AB0867 Interphalangeal Ultrasonography: Clinical and Functional Correlation in Symptomatic Hand Osteoarthritis

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2015-eular.3019 ◽

2015 ◽

Vol 74 (Suppl 2) ◽

pp. 1190.3-1191

Author(s):

N.D.O. Spolidoro Paschoal ◽

J. Natour ◽

F.S. Machado ◽

H.A.V.D. Oliveira ◽

R.N.V. Furtado

Keyword(s):

Hand Osteoarthritis ◽

Functional Correlation

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Night-time immobilization of the distal interphalangeal joint reduces pain and extension deformity in hand osteoarthritis

Rheumatology ◽

10.1093/rheumatology/ket455 ◽

2014 ◽

Vol 53 (6) ◽

pp. 1142-1149 ◽

Cited By ~ 13

Author(s):

F. E. Watt ◽

D. L. Kennedy ◽

K. E. Carlisle ◽

A. J. Freidin ◽

R. M. Szydlo ◽

...

Keyword(s):

Interphalangeal Joint ◽

Hand Osteoarthritis ◽

Distal Interphalangeal Joint ◽

Night Time ◽

Distal Interphalangeal

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Comparison of Prevalence of Osteoarthritis in the Hand: A Multicenter Retrospective Cohort Study

Journal of Hand and Microsurgery ◽

10.1055/s-0040-1715927 ◽

2020 ◽

Author(s):

Jegathesan T. ◽

Camilla J. Stewart ◽

Pei Y. Tong ◽

Wee L. Lam ◽

Vaikunthan Rajaratnam

Keyword(s):

Multiple Logistic Regression Analysis ◽

Asian Population ◽

Interphalangeal Joint ◽

Joint Involvement ◽

Hand Osteoarthritis ◽

Chi Square ◽

Exact Test ◽

Thumb Carpometacarpal Joint ◽

Significant Difference ◽

Thumb Carpometacarpal

Abstract Introduction Several studies have previously been undertaken to investigate the prevalence of radiologic hand osteoarthritis (OA) in Caucasian, Japanese, Chinese, and Arabic populations. To date, there has been no direct international comparison study on the prevalence of radiologic hand OA between a Western and a Southeast Asian population. We hypothesize that there is difference in the pattern of joint involvement among individuals of both populations. Materials and Methods Consecutive hand radiographs from individuals aged 60 years and above were reviewed. Radiographic evidence of osteoarthritis in the various joints in the hands was graded using Kellgren–Lawrence (K-L) score. Chi-square test, Fisher’s exact test, or Student’s t-test was used as appropriate. Multiple logistic regression analysis was performed to evaluate the associations and relationships of radiographic hand OA between joints. Results A total of 194 patients exhibited radiographic OA. Singaporean patients were more likely to have radiographic OA of the thumb interphalangeal joint (IPJ) (65.1%) compared with the thumb carpometacarpal joint (CMCJ; 40.2%); British patients were more likely to have CMCJ (43.3%) OA than thumb IPJ (21.0%). The difference was statistically significant (p = 0.00026). In the Singapore population, it was more likely that a patient had concurrent OA of both thumb and finger joints, whereas in the British population, this was apparent in only the above-80-year-old group. The most commonly affected joint was the left thumb IPJ (joint specific prevalence of 35%) in the Singapore population, and the right index finger distal interphalangeal joint (DIPJ; joint specific prevalence of 41.5%) in the British population. Conclusion Our study, the first study to compare between Singaporean and British populations, showed statistically significant difference in the prevalence of OA in the hands. These findings suggest ethnic and cultural factors play a part in such a distribution trend.

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POS0125 CALCULATING RISK OF HAND OSTEOARTHRITIS PROGRESSION AT TEN YEARS THROUGH A PREDICTION MODEL

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.1126 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 274-275

Author(s):

K. Shah ◽

G. Bullock ◽

A. Silman ◽

D. Furniss ◽

N. Arden ◽

...

Keyword(s):

Risk Factors ◽

Family History ◽

Prediction Model ◽

Odds Ratio ◽

Interphalangeal Joint ◽

Hand Osteoarthritis ◽

C Statistic ◽

Osteoarthritis Progression ◽

History Of ◽

Hand Radiographs

Background:Hand osteoarthritis (OA) is a chronic, progressive disease, commonly affecting middle aged women. OA at the interphalangeal joints (IPJs) or the thumb base are considered different disease subsets (1). Few studies have investigated individual risk factors for IPJ OA progression (2). Prediction models can be used to calculate overall disease risk from multiple risk factors. This can guide prevention and treatment options.Objectives:Develop and internally validate a prediction model for IPJ OA progression.Methods:Data from the Chingford 1000 Women Study (Chingford Study), the largest population-based cohort worldwide assessing hand OA, was used. It is representative of the middle-aged female population in the United Kingdom (3). At baseline, 1,003 women aged 45 to 64 years’ old were recruited, and 693 measurements taken. Hand radiographs were taken at baseline and after ten years, read using the Kellgren-Lawrence (KL) atlas (inter-observer correlation: ≥0.7 (4)).For the current study, participants must have had OA (KL ≥2 in ≥1 IPJ) on baseline hand radiographs. Participants with KL 4 in all 16 IPJs at baseline were excluded. Risk factors from the Chingford Study at baseline were selected by biological plausibility, literature evidence (2), and hand surgeons‘ consensus (5): age (years), occupation (manual versus non manual), OA in ≥1 thumb base (KL ≥2 versus KL<2), body mass index (BMI) (kg/m2), family history of hand OA (yes versus no). The outcome was defined on an ordinal scale for the number of IPJs (up to >5 IPJs) with OA progression (increase by KL ≥1), at ten years’.The prediction model was developed using a penalized proportional odds logistic regression. Odds ratios (95% confidence intervals) were reported for each risk factor. The model was internally validated using 2,000 bootstrap iterations. Model performance was assessed for discrimination (C-statistic), and calibration (C-slope). 3.5% of data was missing, and complete case analysis was used.Results:699 women had baseline hand radiographs: 38 were unreadable, 459 had no IPJ OA. Seven participants had missing data (occupation: 5, BMI: 1, family history: 1) and were excluded. 195 participants were included this study. Median age at baseline was 59 (interquartile range: 8) years.181 (92.8%) participants had OA progression at 10 years (Figure 1). Thumb base OA (odds ratio: 1.32 (0.93 to 1.88)) was most strongly associated with IPJ OA progression (Table 1). C-statistic was 0.57, and calibration slope was 1.38 for the optimism-corrected model.Table 1.Odds ratios for risk factorsRisk factorOdds ratio (95% confidence interval)Age (years)1.02 (0.99 to 1.06)Occupation (manual versus non manual)0.88 (0.60 to 1.29)Thumb base OA (Kellgren-Lawrence grade ≥2 versus <2)1.32 (0.93 to 1.88)Family history of hand OA (yes versus no)1.03 (0.72 to 1.45)Body mass index (kg/m2)1.04 (0.99 to 1.09)OA: OsteoarthritisConclusion:More stringent cut-offs for OA progression would be clinically useful. It was only weakly possible to predict which participants with IPJ OA would progress. This suggests that other risk factors, such as gender, ethnicity and genetics, may be predominant.Figure 1.Hand interphalangeal joints with osteoarthritis progression (Kellgren-Lawrence grade ≥1) at 10 years’ follow upReferences:[1]Kloppenburg M, et al. Research in hand osteoarthritis: time for reappraisal and demand for new strategies. Ann Rheum Dis. 2007;66(9):1157-61.[2]Shah K, et al. Risk factors for the progression of finger interphalangeal joint osteoarthritis: a systematic review. Rheumatol Int. 2020;40(11):1781-1792.[3]Hart DJ, Spector TD. The relationship of obesity, fat distribution and osteoarthritis in women in the general population: the Chingford Study. J Rheumatol. 1993;20:331-335.[4]Hart DJ, et al. Reliability and reproducibility of grading radiographs for osteoarthritis of the hand. Br J Rheum. 1993;32:S1.[5]Shah K, et al. Delphi consensus of risk factors for development and progression of finger interphalangeal joint osteoarthritis. J Hand Surg Eur Vol. 2019;44(10):1089-1090.Acknowledgements:We would like to thank all of the participants of The Chingford 1000 Women Study, Professor Tim Spector, Dr Deborah Hart, Dr Alan Hakim, Maxine Daniels, Alison Turner, James van Santen and Julie Damnjanovic for their time and dedication.Disclosure of Interests:Karishma Shah: None declared, Garrett Bullock: None declared, Alan Silman: None declared, Dominic Furniss: None declared, Nigel Arden Consultant of: Receives personal fees from Pfizer/Lily for consultancy outside the scope of this work, Grant/research support from: Receives grant from Merck outside the scope of this work, Gary Collins: None declared

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