The clinical, functional, and radiological features of hand osteoarthritis: TLAR-osteoarthritis multi-center cohort study
Mehmet Tuncay Duruöz1
, Didem Erdem Gürsoy2, Tiraje Tuncer3, Lale Altan4, Figen Ayhan5, Ajda Bal6, Meral Bilgilisoy7, Lale Cerrahoğlu8, Erhan Çapkın9, Hasan Fatih Çay7, Remzi Çevik10, Berrin Durmaz11, Deniz Dülgeroğlu6, Gülcan Gürer12, Savaş Gürsoy13, Simin Hepgüler11, Sami Hizmetli14, Cahit Kaçar15, Ece Kaptanoğlu16, Taciser Kaya17, Hilal Ecesoy18, Meltem Alkan Melikoğlu19, Kemal Nas20, Hakan Nur3, Şüheda Özçakır4, Merih Sarıdoğan21, Selda Sarıkaya22, İlhan Sezer15, Dilşad Sindel23, Nilay Şahin24, Özlem Şahin25, Ömer Faruk Şendur26, Gülnur Taşçı Bozbaş27, Canan Tıkız8, Hatice Uğurlu27
1Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Marmara University School of Medicine, Istanbul, Turkey
2Department of Physical Medicine and Rehabilitation, Rheumatology Clinic, Prof. Dr. Cemil Taşcoğlu City Hospital, Istanbul, Turkey
3Department of Physical Medicine and Rehabilitation, Akdeniz University School of Medicine, Antalya, Turkey
4Department of Physical Medicine and Rehabilitation, Uludağ University School of Medicine, Bursa, Turkey
5Department of Physical Medicine and Rehabilitation, Atılım University School of Medicine, Ankara, Turkey
6Department of Physical Medicine and Rehabilitation, University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
7Department of Physical Medicine and Rehabilitation, Antalya Training and Research Hospital, Antalya, Turkey
8Department of Physical Medicine and Rehabilitation, Celal Bayar University School of Medicine, Manisa, Turkey
9Department of Physical Medicine and Rehabilitation, Karadeniz Technical University School of Medicine, Trabzon, Turkey
10Department of Physical Medicine and Rehabilitation, Dicle University School of Medicine, Diyarbakır, Turkey
11Department of Physical Medicine and Rehabilitation, Ege University School of Medicine, Izmir, Turkey
12Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Adnan Menderes University School of Medicine, Aydın, Turkey
13Department of Physical Medicine and Rehabilitation, Gaziantep University School of Medicine, Gaziantep, Turkey
14Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Cumhuriyet University School of Medicine, Sivas, Turkey
15Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Akdeniz University School of Medicine, Antalya, Turkey
16Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Başkent University Zübeyde Hanım Application and Research Center, Izmir, Turkey
17Department of Physical Medicine and Rehabilitation, University of Health Sciences, Izmir Faculty of Medicine, Izmir, Turkey
18Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Karamanoğlu Mehmetbey University School of Medicine, Karaman, Turkey
19Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Atatürk University School of Medicine, Erzurum, Turkey
20Department of Physical Medicine and Rehabilitation, Sakarya University School of Medicine, Sakarya, Turkey
21Department of Physical Medicine and Rehabilitation, Istanbul University Cerrahpaşa School of Medicine, Istanbul, Turkey
22Department of Physical Medicine and Rehabilitation, Bülent Ecevit University School of Medicine, Zonguldak, Turkey
23Department of Physical Medicine and Rehabilitation, Istanbul University Istanbul School of Medicine, Istanbul, Turkey
24Department of Physical Medicine and Rehabilitation, Balıkesir University, Balıkesir, Turkey
25Department of Physical Medicine and Rehabilitation, Cumhuriyet University School of Medicine, Sivas, Turkey
26Department of Physical Medicine and Rehabilitation, Adnan Menderes University School of Medicine, Aydın, Turkey
27Department of Physical Medicine and Rehabilitation, Necmettin Erbakan University School of Medicine, Konya, Turkey
Keywords: Function, grip strength, hand osteoarthritis, pain.
Abstract
Objectives: This study aims to evaluate the clinical, functional, and radiological features of hand osteoarthritis (OA) and to examine their relationships in different geographic samples of the Turkish population.
Patients and methods: Between April 2017 and January 2019, a total of 520 patients (49 males, 471 females; mean age: 63.6±9.8 years) with hand OA were included in the study from 26 centers across Turkey by the Turkish League Against Rheumatism (TLAR). The demographic characteristics, grip strengths with Jamar dynamometer, duration of hand pain (month), the severity of hand pain (Visual Analog Scale [VAS]), and morning stiffness were evaluated. The functional disability was evaluated with Duruöz Hand Index (DHI). The Kellgren-Lawrence (KL) OA scoring system was used to assess the radiological stage of hand OA.
Results: The DHI had significant correlations with VAS-pain (r=0.367, p<0.001), duration of pain (r=0.143, p=0.001) and bilateral handgrip strengths (r=-0.228, p=0.001; r=-0.303, p<0.001). Although DHI scores were similar between the groups in terms of the presence of hand deformity (p=0.125) or Heberden's nodes (p=0.640), the mean DHI scores were significantly higher in patients with Bouchard's nodes (p=0.015). The total number of nodes had no significant correlations with the VAS-pain and DHI score (p>0.05). The differences between the groups of radiological hand OA grades in terms of age (p=0.007), VAS-pain (p<0.001), duration of pain (p<0.001), and DHI (p<0.001) were significant. There were no significant differences between radiological hand OA grades according to the duration of the stiffness, grip strength, and BMI (p>0.05 for all).
Conclusion: In our population, the patients with hand OA had pain, functional disability, and weak grip strength. The functional impairment was significantly correlated with the severity of the pain, and the functional status was worse in high radiological hand OA grades.
Citation: Duruöz MT, Erdem Gürsoy D, Tuncer T, Altan L, Ayhan F, Bal A, et al. The clinical, functional, and radiological features of hand osteoarthritis: TLAR-osteoarthritis multi-center cohort study. Arch Rheumatol 2022;37(3):375-382.
The study protocol was approved by the Akdeniz University, Faculty of Medicine Ethics Committee (No: 56, Date: 20.01.2016). . The study was conducted in accordance with the principles of the Declaration of Helsinki.
A written informed consent was obtained from each patient.
Data Sharing Statement:
The data that support the findings of this study are available from the corresponding author upon reasonable request.
All authors contributed to the study design, material preparation, data collection, analysis, interpretation and writing of the manuscript and take full responsibility for the integrity of the study and the final manuscript. All authors read and approved the final manuscript.
The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.
The authors received no financial support for the research and/or authorship of this article.