The effect of radiological hand osteoarthritis on hand function

Area of Science:

• Gerontology
• Rheumatology
• Orthopedics

Background:

• Osteoarthritis (OA) is a prevalent condition affecting joints, including the hands.
• Hand OA can lead to pain, stiffness, and reduced function, impacting daily activities.
• Understanding the relationship between radiological OA and functional limitations is crucial for patient care.

Purpose of the Study:

• To investigate the impact of radiological hand osteoarthritis on various measures of hand function in elderly individuals.
• To assess the correlation between radiographic severity of OA and both objective and subjective functional assessments.
• To identify clinical signs associated with functional decline in patients with hand OA.

Main Methods:

• One hundred elderly patients were assessed, with hand OA defined by Kellgren-Lawrence (K-L) grade ≥ 2.
• Evaluated grip strength, pinch strength, coordination (RAM, FFM), and functional tests (Jebsen, Dreiser's index, HAQ).
• Compared patients with K-L grade ≥ 2 (OA group) to those with K-L grade 0-1 (control group).

Main Results:

• Patients with radiographic hand OA reported significantly worse functional limitations and slower non-dominant hand rapid alternating movement (RAM).
• Higher OA grades (3-4) showed worse outcomes compared to controls and grade 2 OA.
• No significant association was found between radiological hand OA and objective measures like grip and pinch strength.

Conclusions:

• Radiographic hand OA is associated with limitations in self-reported functional abilities and some coordination tasks, but not objective grip or pinch strength.
• Clinical findings such as tenderness, pain, and the presence of Heberden's and Bouchard's nodules negatively affect hand function.
• Dreiser's functional index and the Stanford Health Assessment Questionnaire (HAQ) disability index correlate with the radiological grade of hand OA.