Symptomatic Hand Osteoarthritis Research Articles

Autoimmune thyroid disease modifies the clinical expression of hand osteoarthritis in older people: a third National Health and nutrition examination survey study.

The risk factors linked to hand osteoarthritis (OA) that contribute to its distinct symptoms and clinical presentation are not thoroughly understood. This study aimed to examine whether the autoimmune thyroid disease (AITD) autoantibodies, anti-thyroid peroxidase antibody (TPOAb), and anti-thyroglobulin antibody (TgAb), associate with hand OA and symptomatic hand OA in the Third National Health and Nutrition Examination Survey (NHANES III). We included 2,429 persons from NHANES III ≥60 years of age. Data on hand OA or symptomatic hand OA were examined with respect to their associations with TPOAb and TgAb. Log-binomial and modified Poisson regression models were fit to examine the associations between the anti-thyroid autoantibodies and hand OA or symptomatic hand OA. Higher levels of TPOAb were associated with a higher prevalence of symptomatic hand OA in the unadjusted (PR = 1.182, p = 0.024) and adjusted models after controlling for age, gender, and diabetes (PR = 1.174, p = 0.039). This association was no longer significant when positive TPOAb was considered a categorical variable with four levels and compared with negative TPOAb. TgAb showed a trend toward being positively associated with symptomatic hand OA (p < 0.10). When positive TgAb was considered a categorical variable with four levels and compared with negative TgAb, the highest quartile was associated with a higher prevalence of symptomatic hand OA than negative TgAb in the unadjusted (PR = 2.242, p = 0.008) and adjusted models (PR = 2.045, p = 0.038). There was no significant association between TPOAb or TgAb and hand OA. Higher levels of TPOAb may be associated with the presence of symptomatic hand OA in persons ≥60 years old. Persons ≥60 years old with the highest quartile levels of TgAb may be more likely to present with symptomatic hand OA.

Supplementary management of symptomatic hand osteoarthritis with Pycnogenol®.

The aim of this 4-week pilot registry, supplement study was to assess the effects of Pycnogenol® compared to a standard management on hand osteoarthritis associated with pain. As Pycnogenol® decreases inflammation and pain, chronic use of drugs, causing side effects may be reduced. The registry patients included suffered finger pain associated with hand osteoarthritis All subjects used a standard management (SM). A supplementary group additionally used 150 mg Pycnogenol® per day. In addition, a retrospective group with 40 comparable subjects using oral diclofenac was used for comparison. Forty-two subjects with hand osteoarthritis completed the study. The registry patients were former sport professionals, fishermen and subjects working with their hands in a common manual activity. 22 subjects took Pycnogenol® in addition to standard management and 20 subjects followed the standard management only and served as controls. The two groups were comparable at inclusion. No subject had to stop supplementation or the SM. No side effects were observed. After 4 weeks, spontaneous pain in the morning and pain after work were significantly reduced with Pycnogenol® supplementation compared to controls (P<0.05). Residual pain at rest in the evening was significantly improved after 4 weeks with the supplement compared to controls (P<0.05). The number of subjects requiring pain medication during the 4-week study period was significantly lower in the supplement group (2/22) compared to controls (8/20) (P<0.05). Hand dynamometry results show significant improvement in hand-finger strength (due to decreased pain and stiffness) with the supplement compared to controls (P<0.05). At inclusion, all subjects presented hyperthermic joints, 2°C higher than the surrounding tissues as shown by thermography. After 4 weeks, the number of subjects with hyperthermic joints was lower in the Pycnogenol® group than in controls (P<0.05). Both nonspecific markers of inflammation (ESR and C-reactive protein levels in blood) were significantly lower after 4 weeks in the Pycnogenol® group than in controls (P<0.05). Other routine blood tests were normal at inclusion and at the end of the study. Within 4 weeks, plasma oxidative stress decreased by 14.4% (P<0.05) in the Pycnogenol® group vs 5.5% in the control group. The retrospective comparison with a group of 40 comparable subjects using oral diclofenac showed that after 4 weeks, the efficacy of Pycnogenol® on improving pain in the morning, after work and in the evening, on hand-finger strength and on decreasing C-reactive protein was significantly higher (P<0.05) than in the diclofenac group (comparable, non-parallel group, CNPG). In conclusion, supplementation with Pycnogenol® was well tolerated and effectively controlled pain while improving grip strength in patients with hand osteoarthritis. All supplement subjects showed an improved operativity.

Severity and progression of structural hand OA is not associated with progression of structural knee OA: The IMI-APPROACH cohort

ObjectiveTo investigate whether structural hand OA or its progression is associated with structural knee OA progression after two years in a population with symptomatic knee OA. MethodsWe used baseline and two-year follow-up data from the IMI-APPROACH cohort. Symptomatic hand and knee OA were defined using ACR criteria. Radiographs of hands and knees were scored semi-quantitatively for osteophytes and joint space narrowing (JSN) following the OARSI atlas, and Kellgren-Lawrence (KL) scale. Knee images were also scored quantitatively with the Knee Image Digital Analysis (KIDA). Progression was defined as change above the minimal detectable change on patient level, except for KIDA (most affected knee compartment level). With logistic regression analyses the severity or progression of hand OA was associated with knee OA progression. ResultsIn 221 participants (mean age 66, 77% women, mean BMI 27.7, 19% hand OA), OA progression occurred in 18%–28%, and 9%–38% in hands and knees respectively, depending on features. Baseline structural hand OA features were not significantly associated with knee OA progression, except for hand osteophytes with KIDA osteophytes progression (odds ratio (OR) 1.03, 95% confidence interval (CI) 1.01–1.06). Progression of structural hand OA features was not significantly associated with knee OA progression, except for hand osteophyte or JSN progression, which was significantly associated with knee osteophyte progression (OR 0.44, 95%CI 0.22–0.84 and OR 0.43, 95%CI 0.18–0.94, respectively), and hand osteophyte progression for knee JSN (OR 2.51, 95%CI 1.15–5.48). ConclusionsIn patients with symptomatic knee OA, no consistent associations between baseline structural hand OA or hand OA progression and knee OA progression were shown.

Could sex-specific subtypes of hand osteoarthritis exist? A retrospective study in women presenting to secondary care.

Hand osteoarthritis is more common in women, and its risk increases around the time of the menopause. We set out to describe the timing between menopause and the onset of symptomatic hand osteoarthritis (OA), and associations with the use of hormone replacement therapy (HRT) or its discontinuation, describing any identifiable subgroups of women. Retrospective healthcare-records study of sequential women referred to a specialist hand OA clinic, 2007-2015. Confirmation of hand OA diagnosis was by clinican, by accepted criteria. Demographics and clinical variables were from healthcare-records, recorded by standardised proforma. Outcomes of interest were reported age of onset of hand symptoms, reported age at final menstrual period (FMP), time from FMP to reported onset of hand symptoms and time from cessation of HRT to reported onset of hand symptoms. Exposure categories for systemic HRT use were never users, current users, previous users. Analysis of Variance compared groups; linear regression analysed associations of exposure with outcome. 82/92(89%) of eligible women were post-menopausal, mean age at FMP 49.9 years (SD5.4). In these post-menopausal women, median time from FMP to hand symptom onset was 3 years. 48/82 (59%) developed hand symptoms within the defined peri-menopausal period (FMP ± 4 years), whilst some women developed their symptoms before or after (range -25, 30 years). In women who discontinued HRT prior to symptom onset, the median time from HRT cessation to onset of hand symptoms was 6 months. Past HRT users were older at hand symptom onset than women who had not taken HRT [coeff.4.7 years (0.92, 8.39); P = 0.015]. This study adds to evidence associating the menopause/sex hormone deficiency with hand OA symptom onset in a sizeable subgroup of women (but not all). HRT use/cessation appears to influence the timing of onset of hand OA symptoms. It is not possible to interpret from this type of study whether sex hormone deficiency is causative of disease or modulates its symptoms. It is also not possible to judge whether painful hand osteoarthritis in post-menopausal women is a subtype of disease. Further investigation is indicated of sex-specific subtypes and potential for personalised medicine for post-menopausal women with hand osteoarthritis, as a clearly definable high-risk subgroup.

Short-term clinical outcomes of transarterial embolization for symptomatic hand osteoarthritis refractory to conservative treatment.

The present study aims to assess the short-term clinical outcomes and safety of transarterial embolization (TAE) for symptomatic hand osteoarthritis (OA) refractory to conservative treatment. The present retrospective cohort pilot study included nine patients who underwent TAE for symptomatic OA-associated hand pain in a single tertiary center between November 2022 and January 2023. The baseline and post-procedural OA-associated hand pain and function were assessed using the visual analog scale (VAS) and the Australian Canadian Hand Osteoarthritis Index (AUSCAN). The use of conservative treatment and pain medications was also recorded. Post-procedural adverse events were evaluated according to the Society of Interventional Radiology classification. Compared with the baseline, the overall VAS scores were significantly decreased at 1-week, 1-month, 3-months, and 6-months after TAE (76 ± 15 mm versus 34 ± 18 mm, P < 0.001; 32 ± 11 mm, P < 0.001; 21 ± 15 mm, P < 0.001; 18 ± 19 mm, P = 0.002). Similarly, improvement in the mean total AUSCAN scores (22.0 ± 10.0 versus 13.2 ± 6.6, P = 0.007; 14.11 ± 7.3, P = 0.004; 9.8 ± 6.8, P = 0.004; 9.3 ± 7.4, P = 0.011) were documented. The use of other conservative treatment methods also gradually decreased. There were no severe adverse events reported during the follow-up period. TAE is a feasible and safe treatment method for symptomatic hand OA refractory to conservative treatment. This minimally invasive procedure effectively relieves debilitating OA-associated joint pain and restores hand function with a durable treatment effect.

Association between hyperuricaemia and hand osteoarthritis: data from the Xiangya Osteoarthritis Study

ObjectiveThe pathogenesis of hand osteoarthritis (OA) remains unknown. Hyperuricaemia, which is related to inflammation, may play a role in hand OA, but evidence is lacking. In a large population-based study,...

Association between gut microbiome-related metabolites and symptomatic hand osteoarthritis in two independent cohorts

Since gut microbiome dysbiosis can cause inflammatory disorders by affecting host metabolism, we postulate that the gut microbiome and related metabolites could play a role in hand osteoarthritis. We characterised gut microbiome-related metabolites in people with symptomatic hand osteoarthritis (SHOA) in two independent cohorts. Using data collected from a large-sample community-based observational study (discovery cohort), we assessed the relations of the microbial function and plasma key metabolites related to altered microbial function with SHOA. Finally, we verified the relations of plasma metabolites to SHOA in an independent observational study (validation cohort). In the discovery cohort (n=1359), compared to those without SHOA, participants with SHOA had significantly altered microbial functions related to tryptophan metabolism (Q=0.025). Therefore we measured the plasma tryptophan metabolites and found that participants with SHOA had higher levels of 5-hydroxyindoleacetic acid (odds ratio [OR]=1.25, 95% confidence interval [CI]: 1.09-1.42) and 5-hydroxytryptophol (OR=1.13, 95% CI: 1.04-1.23), but lower levels of indole-3-lactic acid (ILA) (OR=0.85, 95% CI: 0.72-1.00), skatole (OR=0.93, 95% CI: 0.88-0.99) and 3-hydroxyanthranilic acid (OR=0.90, 95% CI: 0.85-0.96). Findings from the validation cohort (n=142) verified that lower levels of ILA were related to SHOA (OR=0.70, 95% CI: 0.53-0.92). Alterations of the microbial function of tryptophan biosynthesis and tryptophan metabolites, especially lower levels of ILA, are associated with SHOA. These findings suggest the role of the microbiome and tryptophan metabolites in developing of SHOA and may contribute to future translational opportunities. National Key Research and Development Plan and National Natural Science Foundation of China.

Patterns and natural history of hand pain in individuals with symptomatic hand osteoarthritis in a prospective cohort study: A post-hoc analysis of a randomised controlled trial

ObjectiveTo investigate the variation in the distribution and the natural history of hand pain over 6 weeks in individuals with symptomatic hand osteoarthritis. DesignPatient-reported outcome data were collected at baseline and weekly for 6 weeks from community-based participants enrolled in a randomised controlled trial. Participants were grouped based on location of significant pain (Visual Analogue Scale, VAS≥40/100 ​mm) (both carpometacarpal (CMC) and interphalangeal (IP), CMC only, and IP only). ResultsAt baseline, of the 106 participants, 55(51.9 %) had pain in both CMC and IP joints, 28(26.4 %) in IP joints only, and 16(15.1 %) in CMC joint only. Those with CMC and IP pain had significantly higher VAS pain [68.1 (2.6) vs 59.3 (3.5) vs 51.2 (4.7)]; Australian Canadian Osteoarthritis Hand Index, (AUSCAN) pain [290.1 (15.7) vs 225.3 (21.2) vs 237.9 (28.4)], stiffness [57.1 (3.7) vs 44.6 (5.0) vs 32.2 (6.7)] and functional limitation [527.5 (30.9) vs 356.0 (41.7) vs 433.3 (55.7)]; and pain sensitization [PainDETECT score 11.1 (1.1) vs 8.1 (1.8) vs 5.8 (1.9)] compared to those with IP or CMC only pain, respectively. All groups showed improvement in outcomes over 6 weeks without significant inter-group differences. ConclusionIn a population with significant hand pain, pain in both CMC and IP joints was most common and identified a more severe phenotype than pain in IP or CMC only with higher pain, more functional limitation and pain sensitization. These data have the potential to inform clinical management of patients with hand pain and patient selection in clinical trials.

Hand osteoarthritis: A fresh look

Hand osteoarthritis (OA) has been the subject of numerous publications in recent years, particularly in the fields of imaging and therapeutics. The imaging studies revealed a good correlation between the presence of synovitis and/or subchondral edema and arthritic joint pain. Several randomized controlled trials (RCTs) have assessed the efficacy of biologics and conventional DMARDs in patients with symptomatic hand OA. No less than six RCTs have evaluated the symptomatic and, in some cases, structural efficacy of anti-IL-1, anti-TNF or anti-IL-6 drugs. Overall, the results of these trials were disappointing – none of them demonstrated superiority over placebo. There were also two negative trials with hydroxychloroquine. In the end, the only trial that was positive evaluated 10mg oral prednisone versus placebo for 6 weeks in patients with flares of hand OA and synovitis visible on ultrasound. While that trial confirms the role of inflammation in hand OA, it should obviously not encourage the long-term use of corticosteroids as a symptomatic treatment.

Effect of 6-week treatment with topical betamethasone dipropionate in patients with symptomatic hand osteoarthritis: A randomized double-blind, placebo-controlled trial

ObjectiveTo examine the efficacy and safety of topical corticosteroid over 6 weeks in patients with symptomatic hand osteoarthritis. DesignIn a randomized, double-blind, placebo-controlled trial, community-based participants with hand osteoarthritis were randomly assigned (1:1) to topical Diprosone OV (betamethasone dipropionate 0.5 ​mg/g in optimised vehicle, n=54) or placebo (plain paraffin, n=52) ointment to painful joints 3 times daily for 6 weeks. Primary outcome was pain reduction [assessed by 100 ​mm visual analogue scale (VAS)] at 6 weeks. Secondary outcomes included changes in pain and function using the Australian Canadian Osteoarthritis Hand Index (AUSCAN), Functional Index for Hand Osteoarthritis (FIHOA), and Michigan Hand Outcomes Questionnaire (MHQ) at 6 weeks. Adverse events were recorded. ResultsOf 106 participants (mean age 64.2 years, 85.9% female), 103 (97.2%) completed the study. Change in VAS at 6 weeks was similar in the Diprosone OV and placebo groups (−19.9 vs. −20.9, adjusted difference 0.6, 95% CI -8.9 to 10.2). There were no significant between-group differences in change in AUSCAN pain [adjusted difference 25.8 (−16.0 to 67.5)], AUSCAN function [21.2 (−55.0 to 97.4)], FIHOA [-0.1 (−1.7 to 1.5)], or MHQ [-1.2 (−6.0 to 3.6)]. Incidence of adverse events was 16.7% in Diprosone OV and 19.2% in placebo group. ConclusionsTopical Diprosone OV ointment, although well-tolerated, was no better than placebo in improving pain or function over 6 weeks in patient with symptomatic hand osteoarthritis. Future studies should consider examining joints with synovitis and whether delivery approaches enhancing transdermal penetration of corticosteroids into joints are effective in hand osteoarthritis. Trial registrationACTRN 12620000599976. Registered May 22, 2020.

Evaluation of the uric acid and hematological parameters in patients with nodal hand osteoarthritis

Objectives: To compare patients with symptomatic nodal hand osteoarthritis (OA) with a control group in respect of inflammation parameters, uric acid, and hematological parameters. Methods: The study included 50 post-menopausal female patients, aged 40-80 years, diagnosed with symptomatic nodal hand OA, and a control group of 50 post-menopausal females in the same age range with no hand OA. Patient data including age, monocyte, neutrophil, lymphocyte, and thrombocyte counts, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) level, uric acid level, and the Kellgren-Lawrence (KL) score obtained from evaluations of hand radiographs, were recorded retrospectively from the hospital information system. The neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and monocyte-lymphocyte ratio (MLR) were calculated. The data were compared between the two groups. Results: The data of 100 females were compared, comprising a patient group of 50 patients with symptomatic nodal OA, and a control group of 50 females. Age, monocyte, neutrophil, lymphocyte, and thrombocyte counts, NLR, PLR, MLR, ESR, CRP, and uric acid level were compared. With the exception of MLR and ESR, no statistically significant difference was determined between the two groups. The MLR was determined to be statistically significantly higher in the control group than in the patient group (p = 0.024). The ESR was determined to be statistically significantly higher in the patient group than in the control group p &amp;lt; 0.001). When patients with a KL score of 2 and 3 were compared, with the exception of age, no other difference was determined. Patients with a KL score of 3 were seen to be significantly older (p = 0.032). Conclusions: ESR was determined to be significantly higher in patients with symptomatic nodal OA. Clarification of the relationship between inflammation, uric acid, and hand OA, which is a heterogeneous disease, will be useful in the follow-up and treatment of patients.

Advances in Understanding and Managing Osteoarthritis: A Comprehensive Review

Osteoarthritis (OA) stands as the foremost prevalent form of arthritis, causing substantial pain and disability worldwide. According to the 2015 Global Burden of Disease study, OA exhibits a significantly higher incidence among women, doubling that of males, and its prevalence escalates with age, particularly peaking after 60 years. Symptoms of OA encompass pain, painful stiffness, and radiographic evidence, with a notable age-standardized prevalence of symptomatic hand OA at 6% and 14.4% for males and females, respectively. In India, a nation of 1.252 billion people, primary knee OA frequency was studied across five distinct locations, revealing significant risk factors such as age, sex, obesity, genetics, and nutritional factors, as well as alignment and cell/extracellular matrix interactions, crucial in articular cartilage physiology. The pathophysiology of OA is typically segmented into three stages: proteolytic degradation (Stage I), synovial inflammation (Stage II), and proinflammatory cytokine involvement (Stage III). Diagnosis relies on various modalities including magnetic resonance imaging (MRI), ultrasound, and optical coherence tomography (OCT). In the management of OA, both pharmacological and non-pharmacological treatments are pivotal. Analgesic drugs are commonly employed, while steroid injections aim to alleviate discomfort and enhance function. Efforts in OA management and understanding continue to evolve, offering hope for improved outcomes and quality of life for affected individuals.

Hormone replacement therapy (conjugated oestrogens plus bazedoxifene) for post-menopausal women with symptomatic hand osteoarthritis: primary report from the HOPE-e randomised, placebo-controlled, feasibility study.

Symptomatic hand osteoarthritis is more common in women than in men, and its incidence increases around the age of menopause, implicating oestrogen deficiency. No randomised controlled trials of hormone replacement therapy (HRT) have been done in people with hand osteoarthritis. We aimed to determine the feasibility and acceptability of a form of HRT (conjugated oestrogens plus bazedoxifene) in post-menopausal women with painful hand osteoarthritis. The HOPE-e feasibility study was a randomised, double-blind, placebo-controlled trial, for which we recruited women aged 40-65 years, for whom 1-10 years had passed after their final menstrual period, with definite hand osteoarthritis and at least two painful hand joints. Participants were recruited across three primary or secondary care sites and from the community and were randomly assigned (1:1) to receive conjugated oestrogens plus bazedoxifene or placebo, orally once every day for 24 weeks, before weaning for 4 weeks until the end of the study. The primary feasibility outcomes were rates of identification, recruitment, randomisation, retention, and compliance of eligible participants, and the likelihood of unmasking. The secondary objective was to generate proof-of-concept quantitative and qualitative data on the acceptability of proposed clinical outcomes for a full trial and adverse events. We used an intention-to-treat analysis, and criteria for progression to a full trial were pre-defined as recruitment of at least 30 participants across all sites in 18 months; a dropout rate of less than or equal to 30% of randomised individuals; and acceptability to the majority of participants, including acceptable rates of adverse events. Due to the COVID-19 pandemic, the recruitment window was reduced to 12-15 months. A proportionately reduced minimum sample size of 22 was judged to be sufficient to test feasibility. This trial was registered at ISRCTN, ISRCTN12196200. From May 9, 2019 to Dec 31, 2020, 434 enquiries or referrals were received. We did 96 telephone pre-screens; of the 35 eligible participants, seven were excluded as ineligible at the telephone or face-to-face screening and 28 (80% [95% CI 63-92]) were randomly assigned. Of the 406 who were not randomly assigned, 250 (62%) were ineligible (with contraindicated medications accounting for 50 [20%] of these), 101 (25%) did not respond to further enquiries, and 55 (14%) chose not to proceed (with the most common reason being not wanting to take a hormone-based drug). All 28 randomised participants completed all follow-up assessments with high compliance and outcome measure completeness. All three adverse event-related treatment withdrawals were in the placebo group. No serious adverse events were reported. Participants and investigators were successfully masked (participant Bang's blinding index placebo group 0·50 [95% CI 0·25-0·75]). The trial met the prespecified criteria for progression to a full trial. This first-ever feasibility study of a randomised controlled trial of HRT for post-menopausal women with painful hand osteoarthritis met its progression criteria, although it was not powered to detect a clinical effect. This outcome indicates that a full trial of an HRT in this population is feasible and acceptable and identifies potential refinements with regard to the design of such a trial. Research for Patient Benefit programme, National Institute for Health Research.

Treating post-menopausal women with symptomatic hand osteoarthritis with hormone replacement therapy.

Hand osteoarthritis is a common, painful, and functionally limiting condition that commonly affects post-menopausal women. There is a gap in our understanding of the underlying pathobiology of hand osteoarthritis. Conventional treatment for painful joints that arise from hand osteoarthritis includes non-surgical options, such as systemic analgesics, intra-articular steroid injections, and splinting. Surgical options are available when non-surgical interventions are not effective and vary depending on the type of joint in the finger, thumb, or wrist that is symptomatic.

Development of a prediction model to determine responders to conservative treatment in people with symptomatic hand osteoarthritis: A secondary analysis of a single-centre, randomised feasibility trial

BackgroundConservative treatments are beneficial for people with hand osteoarthritis (OA). ObjectiveIt was the purpose of this study to develop and internally validate both a basic model and a more complex model that could predict responders to conservative treatments in people with hand OA. DesignThis was a secondary analysis of a single-centre, randomised feasibility study. MethodsFifty-nine participants (34 responders) with hand osteoarthritis were recruited from the general population. Participants were randomised to receive either advice alone, or advice in combination with blood flow restriction training (BFRT), or traditional high intensity training (HIT). Participants underwent supervised hand exercises three times per week for six weeks. The OMERACT-OARSI criteria were utilised to determine responders vs non responders to treatment at the end of six weeks. A basic logistic regression model (treatment type, expectations, adherence) and a more complex logistic regression model (basic model variables plus pain catastrophising and neuropathic pain features) were created. Discrimination ability, and calibration were assessed. Internal model validation through bootstrapping (200 repetitions) was utilised to calculate the prediction model optimism. ResultsThe results showed that the basic model presented with acceptable discrimination (optimism corrected c-statistic: 0.72, 95% CI 0.71–0.73) and calibration (slope = 1.41; intercept = 0.68). The more complex model had better discrimination but poorer calibration. ConclusionA prediction tool was created to provide an individualised estimate of treatment response in people with hand OA. Future studies will need to validate this model in other groups of patients. Trial registrationhttps://www.anzctr.org.au/- ACTRN12617001270303.

Neglect-like symptoms and their relationships with other clinical features in people with hand osteoarthritis: An exploratory study

BackgroundSymptomatic hand osteoarthritis (OA) is a debilitating condition. Body schema impairments such as neglect-like symptoms have been previously reported in people with symptomatic hand OA, however, little is known about their clinical importance, or relationships with other clinical features. ObjectivesThe aim of this cross-sectional study was to assess the prevalence of neglect-like symptoms in painful hand OA and their association with measures of depression, pain catastrophising, sleep quality, function, pain interference and pain duration whilst controlling for important covariates. DesignSecondary analysis of cross-sectional study. MethodsLogistic regression with age, sex, and worst pain intensity as covariates were utilised to assess differences between participants with and without neglect-like symptoms. ResultsA total of 121 participants were recruited. Sixty-one percent of participants presented with neglect-like symptoms. Participants with longer pain duration had greater odds of presenting with neglect-like symptoms (OR: 1.10 95%CI: 1.01 to 1.19; p = 0.012). No difference was observed for depression, pain catastrophising, sleep quality, function, or pain interference. ConclusionsA large proportion of participants with symptomatic hand OA reported neglect-like symptoms, the presence of which was associated with longer pain duration.

Metacarpophalangeal Joint Impairment in Hand Osteoarthritis and Its Association With Mechanical Factors: Results From the Digital Cohort Osteoarthritis Design Hand Osteoarthritis Cohort.

To determine the prevalence, distribution, and characteristics associated with radiographic metacarpophalangeal (MCP) joint osteoarthritis (OA). This was a cross-sectional study of baseline data from the Digital Cohort Osteoarthritis Design, a French monocentric cohort including patients with symptomatic hand OA. We evaluated the prevalence of radiographic MCP joint OA, defined as ≥2 MCP joints with a Kellgren/Lawrence score of ≥2. We compared the prevalence of MCP joint OA in the dominant and nondominant hands. Associations between radiographic MCP joint OA and patient characteristics were studied using univariable and multivariable logistic regression. Radiographic MCP joint OA was present in 138 of the 425 patients (32.5%) but was not severe. Patients with MCP joint OA had a mean age of 69.2 ± 6.9 years, a body mass index of 25 ± 4.2 kg/m2 , and 86.2% were women. MCP joint OA was more frequent in the dominant hand and predominated at the first and second MCP joints. In the multivariable analysis, MCP joint OA was associated with older age (odds ratio [OR] 1.05 [95% confidence interval (95% CI) 1.01, 1.10] for each year), manual occupation (OR 3.74 [95% CI 1.21, 11.54]), scaphotrapezial OA (OR 2.18 [95% CI 1.27, 3.72]), and a high number of proximal interphalangeal joints with radiographic OA. MCP joint OA was not associated with metabolic syndrome or hand OA symptoms. In this cross-sectional study using a hospital-based hand OA cohort, radiographic MCP joint OA was frequent and associated with structural hand OA features rather than with symptom severity. Our results suggest that the involvement of MCP joints in hand OA is predominantly related to mechanical rather than systemic factors in this population.

Comparison of the effectiveness of peloid and paraffin treatment for symptomatic hand osteoarthritis in women: a single-blind randomized controlled study.

Although peloid and paraffin treatments may have a positive effect in the short term on pain, functional status, hand grip strength, and quality of life in patients with hand osteoarthritis (HOA), there are no comprehensive and comparative studies of these therapies for HOA. The aim of our study was to evaluate the short-term effects of peloid and paraffin treatments in symptomatic HOA patients. Eighty female patients diagnosed with HOA were randomly divided into two equal groups: peloid group (peloid therapy and home exercise) and paraffin group (paraffin therapy and home exercise). Peloid and paraffin applications were performed over 3 weeks for a total of 15 sessions. Patients were evaluated with visual analog scale (VAS)-rest, -activity, and -handgrip for pain, Jamar hand dynamometer for grip strength, Australian/Canadian (AUSCAN) Osteoarthritis Hand Index for function, health assessment questionnaire (HAQ) for physical activity, Beck depression inventory (BDI) for depression, and short form-36 (SF-36) for quality of life. Evaluations were performed before treatment, in the 3rd week, and 1 month after treatment. For all parameters except SF-36, statistically significant improvements were observed in short-term evaluations compared to the baseline in both groups (p = .000). Reductions in HAQ scores in the 3rd week and 1st month (p = .001 and p = .003), and the decrease in BDI scores in the 3rd week (p = .005) was statistically significantly higher in the peloid group. Improvements in some subparameters of the SF-36 were statistically significant in favor of the peloid group. In female patients with HOA, both groups experienced similar positive effects on pain, functional status, and hand grip strength for up to one month, but the peloid group was found to be superior in the short term in terms of physical activity and some quality of life parameters. Peloid therapy can be preferred as a natural and reliable method for symptomatic HOA.

MRI and ultrasonography for detection of early interphalangeal osteoarthritis.

To assess the interest of MRI and ultrasonography (US) in identifying early and advanced interphalangeal (IP) OA. We conducted a case-control study including patients with symptomatic hand OA (n=33) and young healthy volunteers (n=26). Proximal and distal IP joints were graded according to Kellgren and Lawrence (KL) grades. In OA patients, we separated IP joints into 2 groups: "at risk of OA" joints (potential early pre-radiographic OA joints, KL=0) and OA joints (KL=2-4). All IP joints from healthy participants were KL=0 and were considered strictly normal IP joints. Concurrently, synovitis, effusion, erosions, osteophytes, bone marrow lesions, cysts and cartilage space loss were graded by MRI and/or US. We assessed their prevalence, severity and diagnostic performance in hand OA and then compared normal IP joints from healthy participants and "at risk of OA" IP joints from OA patients as well as "at risk of OA" and OA IP joints from OA patients. The prevalence and grade of most MRI/US-detected lesions were higher in IP joints from OA patients than healthy participants. Except for osteophyte assessment, MRI seemed more sensitive than US. We found more MRI/US-detected lesions in "at risk of OA" IP joints than normal joints but also in OA than "at risk of OA" joints from OA patients. US appeared both sensitive and specific for detecting osteophytes in joints without radiographic abnormalities. MRI and US give good performance for detecting radiographic and pre-radiographic OA lesions and could be interesting tools to identify early hand OA.

Botulinum toxin A: a short-term treatment option for base-of-thumb osteoarthritis?

Osteoarthritis is the most common chronic joint disorder. The prevalence of symptomatic hand osteoarthritis for adults (aged 40–84 years) is 16% among women and 8% among men in the USA.2 Base-of-thumb osteoarthritis is located at the first carpometacarpal joint, which causes pain and is particularly challenging given the joint's central role in hand function, making it hard to perform everyday activities, especially when requiring a pinch grip (eg, when eating and dressing).