Abstract
IntroductionThe primary complaint of patients with hand osteoarthritis (OA) is frequently the inelegant appearance of their hands. Only one study has been conducted to assess the magnitude of and identify the determinants of aesthetic discomfort in hand OA.MethodsThe LIège Hand Osteoarthritis Cohort is a prospective cohort of 203 patients diagnosed with hand OA. At baseline, these patients rated their aesthetic discomfort on a 100-mm visual analogue scale (VAS) and used a Likert scale (range 0–7) to quantify the magnitude of their aesthetic damage.ResultsThe median value of the aesthetic discomfort VAS was 35.0 [interquartile range (Q1–Q3) 6.0–59.0]. The median damage was rated 3.0 (Q1–Q3 1.0–4.0), corresponding to a moderate level. Both were significantly (p < 0.02) associated with the female gender, the duration of hand OA, the radiological severity of OA (Verbruggen–Veys and Kellgren–Lawrence scales) and pain, disability, or stiffness [Australian Canadian Osteoarthritis Hand Index (AUSCAN) and Functional Index for Hand Osteoarthritis ]. After a stepwise analysis, the parameters correlated to the aesthetic discomfort were the presence of erosive joints (p = 0.0048), the AUSCAN score (p < 0.0001), the number of joints with severe radiological damage (p = 0.023), and gender (p = 0.0009). For aesthetic damage, the parameters associated were AUSCAN score (p < 0.0001), duration of hand OA >10 years (p = 0.001), and presence of erosive joints (p < 0.0001). Compared with patients with low aesthetic discomfort (VAS ≤33 mm), those with the highest discomfort (VAS ≥66 mm) had more erosive OA (p = 0.014), a higher Verbruggen and Veys score (p = 0.0039), and a higher AUSCAN score (p < 0.001).ConclusionsAesthetic discomfort and damage are significant complaints in patients with hand OA. The determinants of the magnitude of these are gender, radiological severity, duration of hand OA, presence of erosive joints, and impact on pain, function, and stiffness as assessed with the AUSCAN.Electronic supplementary materialThe online version of this article (doi:10.1186/s13075-015-0807-y) contains supplementary material, which is available to authorized users.
Highlights
The primary complaint of patients with hand osteoarthritis (OA) is frequently the inelegant appearance of their hands
Only one study has suggested that aesthetic discomfort is a major concern for a significant number of patients with hand OA (HOA), women, those with a high burden of HOA disease, and those with erosive OA; in addition, aesthetic discomfort is associated with depression, anxiety, and poor health-related quality of life (HRQoL) [11]
The objectives of the present study were to assess the magnitude and the determinants of the aesthetic discomfort in HOA using the baseline data of the LIège Hand Osteoarthritis Cohort (LIHOC), a prospective study of 203 patients diagnosed with HOA who are prospectively followed to better understand the impact of HOA on HRQoL and health resource use
Summary
The primary complaint of patients with hand osteoarthritis (OA) is frequently the inelegant appearance of their hands. A systematic review of the literature published in 2011 suggested that HOA may have almost as great an impact as rheumatoid arthritis (RA) on HRQoL [9]. Whereas dissatisfaction with hand appearance is frequently the presenting complaint of patients with HOA, no specific tool exists for its measurement and few studies have addressed aesthetic discomfort [9, 11]. Only one study has suggested that aesthetic discomfort is a major concern for a significant number of patients with HOA, women, those with a high burden of HOA disease, and those with erosive OA; in addition, aesthetic discomfort is associated with depression, anxiety, and poor HRQoL [11]
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