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Aggressive Nature of Hand Osteoarthritis Highlighted by New Study
June 20 2007
In just two years, patients with hand osteoarthritis (OA) experienced a
significant increase in pain and functional limitations, according to
new data presented here at the Annual European Congress of Rheumatology
(EULAR). Statistically significant radiological progression was also
detected in 20% of subjects.
OA is the most common form of arthritis. It generally affects
older people, especially women and can occur in multiple areas of the
hand and wrist, causing pain and stiffness and affecting everyday
activities requiring fine motor control and hand grip, such as writing.
Over time, if left untreated, the bones that make up the joint can lose
their normal shape, causing further pain and limited motion. However,
knowledge about the progression of hand OA and effective therapies to
prevent its progression has been lacking.
Led by Dr. Stella Botha-Scheepers of Leiden University, The
Netherlands, this study followed 172 patients (mean age 60.5 years,
78.5% women) with hand OA (defined by the American College of
Rheumatology criteria) for two years, assessing: pain intensity upon
lateral pressure in the DIP, IP, PIP and CMC 1 joints on a four-point
scale; self-reported hand pain and functional limitations with
subscales of the Australian/Canadian Osteoarthritis Hand Index (AUSCAN
LK 3.0); and osteophytes and joint space narrowing in the right and
left DIP joints, IP joints of the thumbs, PIP joints and CMC 1 joints
through standardized radiographs.
Despite a relatively short follow-up
period of two years, statistically significant increases in pain
intensity on lateral pressure standard response mean (SRM) 0.67),
AUSCAN pain scores (SRM 0.25) and AUSCAN function scores (SRM 0.23)
occurred. Statistically significant radiological progression was also
seen in 20% of patients, in terms of joint space narrowing (SRM 0.34)
and osteophytes (SRM 0.35), with progression of osteophytes occurring
more often in women and middle-aged patients, and especially in women
in an early post-menopausal stage.
Dr. Botha-Scheepers commented: "The findings of this
study underline the critical need for early, effective intervention in
hand OA to prevent irreversible progression, given the dramatic
deterioration of clinical and radiological disease status seen in just
two years."
Hand OA tends to appear in a predictable pattern, most
commonly affecting the small joints of the fingers and the joint at the
base of the thumb. It can be diagnosed by medical examination and
X-rays of the hand. Treatment options for arthritis of the hand and
wrist include oral medication, injections, splinting and surgery.
SOURCE: The European League Against Rheumatism
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