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Distribution of joint involvement in women with hand osteoarthritis and associations between joint counts and patient-reported outcome measures

Objective: This study investigated the association between clinically assessed finger joint involvement (joint counts) and patient outcome measures in hand osteoarthritis (HOA). Methods: Women with HOA (n = 190) (between 50 and 70 years of age, mean 61.6 years) completed a clinical examination, which included assessment of finger joints (carpometacarpal (CMC) joints, metacarpophalangeal (MCP) joints, proximal interphalangeal (PIP) joints and distal interphalangeal (DIP) joints) with regard to tenderness/pain, soft tissue swelling, bony enlargement and limited motion, measurement of grip strength and completion of a booklet with questionnaires (Australian/Canadian Osteoarthritis Hand Index (AUSCAN), Arthritis Impact Measurement Scales 2 (AIMS2), Health Assessment Questionnaire (HAQ), Short Form 36 assessment (SF-36) and visual analogue scale for pain (VAS pain)). Results: DIP joints were most frequently affected. Presence of pain in any PIP or DIP finger joint was associated with worse health status. The three other categories of joint findings were generally also associated to worse health status, but associations were mostly not statistically significant. Correlations between tender and swollen joint counts in most finger joint areas and scores of specific outcome measures (AUSCAN, AIMS2 hand + finger), VAS pain and grip strength were mild to moderate, whereas correlations between joint counts and scores of general physical function, general pain and other dimensions of health (AIMS2 and SF-36) were generally low. Conclusions: The association between painful CMC, PIP and DIP joint counts and worse scores for key dimensions of health was moderate.