2023 EULAR classification criteria for hand osteoarthritis.

Area of Science:

• Rheumatology
• Osteoarthritis Research
• Clinical Diagnostics

Background:

• Hand osteoarthritis (OA) diagnosis relies on various clinical and radiographic features.
• Existing classification criteria may require refinement for improved accuracy and consistency.
• Standardized criteria are essential for reliable clinical studies and patient management.

Purpose of the Study:

• To develop and validate new classification criteria for overall hand OA, interphalangeal OA, and thumb base OA.
• To establish criteria based on self-reported data and radiographic evidence.
• To compare the performance of the newly developed European Alliance of Associations for Rheumatology (EULAR) criteria with existing American College of Rheumatology (ACR) criteria.

Main Methods:

• A three-phase development process involving identification of discriminating criteria, consensus-based evaluation, and scoring system refinement.
• Utilizing self-reported data (age, morning stiffness duration) and radiographic features (osteophytes, joint space narrowing, symptom-radiograph concordance).
• Comparing sensitivity and specificity of EULAR criteria against 1990 ACR criteria in multiple datasets.

Main Results:

• Hand OA classification incorporates age, symptom duration, osteophyte/joint space narrowing counts, and symptom-radiograph concordance.
• A scoring system was developed with a threshold of 9 points for overall hand OA and 8 points for interphalangeal/thumb base OA.
• EULAR criteria showed superior sensitivity in initial data but comparable performance to ACR criteria in external cohorts.

Conclusions:

• International experts successfully developed the EULAR criteria for classifying hand OA subtypes.
• The criteria are based on a rigorous methodology integrating clinical and radiographic data.
• These new EULAR criteria provide a standardized approach for hand OA classification in clinical research.