Functional disability of Filipino patients with hand Osteoarthritis seen at a Rheumatology outpatient clinic of a Tertiary Government Hospital

ABSTRACT

Introduction@#Osteoarthritis (OA) is a common joint disease which may cause functional limitation in daily activities. The aim of this study is to determine disability of patients with hand osteoarthritis (HOA) using the Disability of Arm, Shoulder and Hand (DASH) questionnaire and to determine association of risk factors to the development of HOA. @*Methods@#This is a cross-sectional study done in a tertiary government hospital. Patients seen at the rheumatology outpatient clinic aged 40 years and above, diagnosed with primary OA of hands, knees, hips and spine based on American College of Rheumatology criteria and who gave written informed consent, were included. Patient characteristics were extracted. Descriptive statistics were used. Those with HOA were compared to those without HOA, as to biomechanical stress, menopause, body mass index (BMI) and family history. They were made to complete the DASH questionnaire. Data was analyzed using chi-square and logistics regression analysis to determine association of risk factors for HOA. @*Results@#One hundred fifty patients with primary OA were included; 61.3% were between 60-79 years, 92% were female. Forty-one percent were obese, 55.3% had family history of OA. There were 88 cases of HOA (59%). Mean age at onset is 58.2±8.8 years, mean age at diagnosis is 61.8±9.6 years. The most common complaints were stiffness and pain (60.3%), stiffness only (29.5%) and pain only (10.2%). The average DASH is 28.7±15.6 (mild disability), seen in 59.1%, moderate disability in 37.5% and severe in 3.4%. Among the risk factors for the development of HOA, there was a trend for menopause, BMI and biomechanical stress to increase risk of HOA. Among the biomechanical factors, cooking, laundry and cleaning showed a trend toward increasing risk two-fold.@*Conclusion@#This study showed that half of patients with primary OA in the study had HOA that was mildly disabling in a majority, and moderately disabling in 1/3 of cases. There may be correlation with biomechanical factors in its development. Other important risk factors for its development need to be further studied in a larger cohort of patients.