Hand osteoarthritis: correlation between functional evaluation, imaging and disease activity

ABSTRACT

This study aimed at investigating the relationship between functional evaluation, imaging and disease activity in hand Osteoarthritis. Twenty-five patients fulfilling the ACR criteria for classification of hand osteoarthritis were enrolled in this study. Full demographic data was obtained and all patients underwent thorough rheumatologic examination which included tender joint count as well as node count. The patients completed the AUSCAN questionnaire. Grip and pinch strength was measured bilaterally. Postero-anterior hand radiographs were taken and power doppler ultrasonography was performed on both hands. They all had ESR and ultrasensitive CRP measured. Seventeen patients [68%] had tender joints, 22 patients [88%] had nodes. Kellgren-Lawrence grading of the x-rays ranged from 2- 4. Grip and pinch strength were not correlated with OA severity or disease activity. Seventeen patients [68%] had positive power doppler findings indicative of synovitis. There was no correlation between doppler findings and hand function. Twenty-three patients [92%] had elevated ESR and twenty-four patients [96%] had elevated ultrasensitive CRP. There was a positive correlation between CRP and OA severity. However, CRP did not correlate with hand function. Tender joint count was positively correlated with pain, stiffness and functional disability [AUSCAN]. Tender joints also correlated with ESR. There was no correlation between tender joint count and power doppler findings. Tender joint count correlates well with lab findings and AUSCAN scoring. However, hand function measured both objectively and subjectively does not correlate with acute phase reactants or power doppler ultrasonography and radiographic findings in hand OA. It seems that hand function does not reflect disease activity or severity