Hand Function in Osteoarthritis
Almost half of the population has osteoarthritis of the hand (OAH). Fortunately, more than half are asymptomatic. Unfortunately, almost half have symptoms, more commonly in women than in men. The most common symptoms relate to disfigurement of the digits. Less commonly, there is pain and digital deformity limits function, with or without pain. Symptoms may be constant but also may be cyclic and irregular. There is also a spectrum of OAH from hypertrophic (nodal) to destructive (erosive) disease, the latter having more often and more severe symptoms. It is only in the last few decades that validated instruments have been developed to measure the impact of OAH. The Australian/Canadian Osteoarthritis hand index and the functional index for hand osteoarthritis have been validated in several languages. These instruments define the severity of hand osteoarthritis and have been sensitive to change in well-conducted clinical trials. These instruments perform as well as or better than simple nonspecific pain scales and supplement quality-of-life scales. These instruments are invaluable as new therapies are developed that treat the symptoms of OAH or to potentially alter the progression of OAH.
KeywordsGrip Strength Joint Space Narrowing Pinch Strength Dash Score Erosive Change
- 1.Heberden W. Commentaries on the history and cure of diseases [De nodis digitorum. Commentarii de morborum historia et curatione]. London: T. Payne; 1802.Google Scholar
- 6.ACR Subcommittee on Classification Criteria of Osteoarthritis. Altman RD, Chairman. The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hand. Arthritis Rheum. 1990;33:160110.Google Scholar