Hand Function in Osteoarthritis

  • Roy D. AltmanEmail author


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.


Grip Strength Joint Space Narrowing Pinch Strength Dash Score Erosive Change 
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  1. 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
  2. 2.
    Pereira D, Peleteiro B, Araujo J, et al. The effect of osteoarthritis definition on prevalence and incidence estimates: a systematic review. Osteoarthritis Cartilage. 2011;19:1270–85.PubMedCrossRefGoogle Scholar
  3. 3.
    Stamm TA, Machold K, Sahinbegovic E, et al. Daily functioning and health status in patients with hand osteoarthritis: fewer differences between women and men than expected. Wein Klin Wochenschr. 2011;123:603–6.CrossRefGoogle Scholar
  4. 4.
    Ishimori ML, Altman RD, Cohen MJ, et al. Heritability patterns in hand osteoarthritis: the role of osteophytes. Arthritis Res Ther. 2010;12:R180.PubMedCentralPubMedCrossRefGoogle Scholar
  5. 5.
    Dillon CF, Hirsch R, Rasch EK, Gu Q. Symptomatic hand osteoarthritis in the United States: prevalence and functional impairment estimates from the third U. S. National Health and Nutrition Examination Survey, 1191–1194. Am J Phys Med Rehabil. 2007;86:12–21.PubMedCrossRefGoogle Scholar
  6. 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
  7. 7.
    Rees F, Doherty S, Hui M, et al. Distribution of finger nodes and their association with underlying radiographic features of osteoarthritis. Arthritis Care Res. 2012;64:533–8.CrossRefGoogle Scholar
  8. 8.
    Nicholls EE, Van der Windt DAWM, Jordan JL, et al. Factors associated with the severity and progression of self-reported hand pain and functional difficulty in community-dwelling older adults: a systematic review. Muscoskel Care. 2012;10:51–62.CrossRefGoogle Scholar
  9. 9.
    Addimanda O, Mancarella L, Dolzani P, et al. Clinical associations in patients with hand osteoarthritis. Scand J Rheumatol. 2012;41:310–3.PubMedCrossRefGoogle Scholar
  10. 10.
    Zhang W, Doherty M, Leeb BF, et al. EULAR evidence based recommendations for the diagnosis of hand osteoarthritis—report of a task force of the EULAR standing committee for international clinical studies including therapeutics (ESCISIT). Ann Rheum Dis. 2009;68:8–17.PubMedCrossRefGoogle Scholar
  11. 11.
    Kellgren JH, Lawrence JS. Radiologic assessment of osteoarthrosis. Ann Rheum Dis. 1947;16:494–501.CrossRefGoogle Scholar
  12. 12.
    Kallman DA, Wigley FM, Scott WW, et al. New radiographic grading scales for osteoarthritis of the hand. Arthritis Rheum. 1989;32:1584–91.PubMedCrossRefGoogle Scholar
  13. 13.
    Altman RD, Gold G. Radiographic atlas for osteoarthritis of hand, hip and knee. Osteoarthritis Cartilage. 2007;15(Suppl A):A1–56.PubMedCrossRefGoogle Scholar
  14. 14.
    Verbruggen G, Veys EM. Erosive and non erosive hand osteoarthritis. Use and limitations of two scoring systems. Osteoarthritis Cartilage. 2000;8(Suppl A):S45–54.PubMedCrossRefGoogle Scholar
  15. 15.
    Jonsson H, Helgadottir GP, Aspelund T, et al. The use of digital photographs for the diagnosis of hand osteoarthritis: the AGES-Reykjavik study. BMC Musculoskelet Disord. 2012;12:20–33.CrossRefGoogle Scholar
  16. 16.
    Maheu E, Altman RD, Bloch DA, et al. Design and conduct of clinical trials in patients with osteoarthritis of the hand: recommendations from a task force of the Osteoarthritis Research Society International. Osteoarthritis Cartilage. 2006;14:303–22.PubMedCrossRefGoogle Scholar
  17. 17.
    Dreiser RL, Maheau E, Guillou GB, et al. Validation of an algofunctional index for osteoarthritis of the hand. Rev Rhum Engl Ed. 1995;62(6 (Suppl 1)):43S–53.PubMedGoogle Scholar
  18. 18.
    Duruoz MT, Poiraudeau S, Fermanian J, et al. Development and validation of a rheumatoid hand functional disability scale that assesses functional handicap. J Rheumatol. 1996;23:1167–72.PubMedGoogle Scholar
  19. 19.
    Poiraudeau S, Chevalier X, Conrozier T, et al. Reliability, validity and sensitivity to change of the Cochin hand functional disability scale in hand osteoarthritis. Osteoarthritis Cartilage. 2001;9:570–7.PubMedCrossRefGoogle Scholar
  20. 20.
    Bellamy N, Campbell J, Haraoui G, et al. Dimensionality and clinical importance of pain and disability in hand osteoarthritis: development of the Australian/Canadian (AUSCAN) Osteoarthritis Hand Index. Osteoarthritis Cartilage. 2002;10:855–62.PubMedCrossRefGoogle Scholar
  21. 21.
    Hill S, Dziedzic KS, Ong SN. The functional and psychological impact of hand osteoarthritis. Chronic Illn. 2010;6:101–10.PubMedCrossRefGoogle Scholar
  22. 22.
    Haugen IK, Moe RH, Slatkowsky-Christensen B, et al. The AUSCAN subscales, AIMS-2 hand/finger subscale, and FIOHA were not unidimensional scales. J Clin Epidemiol. 2011;64:1039–46.PubMedCrossRefGoogle Scholar
  23. 23.
    Lee HJ, Paik N-J, Lim J-Y, et al. The impact of digit-related radiographic osteoarthritis of the hand on grip-strength and upper extremity disability. Clin Orthop Relat Res. 2012;470:2202–8.PubMedCentralPubMedCrossRefGoogle Scholar
  24. 24.
    Wittock R, Cruyssen BV, Verbruggen G. Predictors of functional impairment and pain in erosive osteoarthritis of the interphalangeal joints: comparison with controlled inflammatory arthritis. Arthritis Rheum. 2012;64:1430–6.CrossRefGoogle Scholar
  25. 25.
    Moe RH, Garratt A, Slatkowsky-Christensen B, et al. Concurrent evaluation of data quality, reliability and validity of the Australian/Canadian osteoarthritis hand index and the functional index for hand osteoarthritis. Rheumatology. 2010;49:2327–36.PubMedCrossRefGoogle Scholar
  26. 26.
    Stamm T, Geyh S, Cieza A, et al. Measuring functioning in patients with hand osteoarthritis—content comparison of questionnaires based on the International Classification of Functioning, Disability and Health (ICF). Rheumatology. 2006;45:1534–41.PubMedCrossRefGoogle Scholar
  27. 27.
    Allen KD, Jordan JM, Renner JB, Kraus VB. Relationship of global assessment of change to AUSCAN and pinch and grip strength among individuals with hand osteoarthritis. Osteoarthritis Cartilage. 2006;14:1281–7.PubMedCrossRefGoogle Scholar
  28. 28.
    Allen KD, DeVillis RF, Renner JB, et al. Validity and factor structure of the AUSCAN osteoarthritis hand index in a community-based sample. Osteoarthritis Cartilage. 2007;15:83.836.CrossRefGoogle Scholar
  29. 29.
    Haugen IK, Slatkowsky-Christensen B, Lessem J, Kvien TK. The responsiveness of joint counts, patient-reported measures and proposed composite scores in hand osteoarthritis: analyses from a placebo-controlled trial. Ann Rheum Dis. 2010;69:1436–40.PubMedCrossRefGoogle Scholar
  30. 30.
    Dziedzic KS, Hill S, Nicholls E, et al. Self management, joint protection and exercises in hand osteoarthritis: a randomized controlled trial with cost effective analysis. BMC Musculoskelet Disord. 2011;12:156–71.PubMedCentralPubMedCrossRefGoogle Scholar
  31. 31.
    Bijsterbosch J, Wassenaar MJ, le Cessie S, et al. Doyle index is a valuable additional pain measure in osteoarthritis. Osteoarthritis Cartilage. 2010;18:1046–50.PubMedCrossRefGoogle Scholar
  32. 32.
    Hodkinson B, Maheu E, Michon M, et al. Assessment and determinants of aesthetic discomfort in hand osteoarthritis. Ann Rheum Dis. 2012;71:45–9.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.Department of Medicine/RheumatologyUCLALos AngelesUSA

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