EXTENDED REPORT

Research in hand osteoarthritis: time for reappraisal and demand for new strategies. An opinion paper

Margreet Kloppenburg¹, Tanja Stamm², Iain Watt³, Franz Kainberger⁴, Tim E Cawston⁵, Fraser N Birrell⁵, Ingemar F Petersson^6,7, Tore Saxne⁷, Tore K Kvien⁸, Barbara Slatkowsky-Christensen⁸, Maxime Dougados⁹, Laure Gossec⁹, Ferdinand C Breedveld¹, Josef S Smolen²

¹ Leiden University Medical Center, Department of Rheumatology, The Netherlands
² Medical University of Vienna, Department of Internal Medicine III, Division of Rheumatology, Austria
³ Leiden University Medical Center, Department of Radiology, The Netherlands
⁴ Medical University of Vienna, Department of Radiology, Austria
⁵ School of Clinical Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
⁶ Spenshult Hospital for Rheumatic Diseases, Oskarström, Sweden
⁷ Lund University Hospital, Department of Rheumatology, Lund, Sweden
⁸ Diakonhjemmet Hospital, Department of Rheumatology, Oslo, Norway
⁹ René-Descartes University, Medicine Faculty; APHP, Cochin Hospital, Rheumatology B Department, Paris, France

Correspondence to:
Margreet Kloppenburg
MD PhD, Department of Rheumatology, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands; g.kloppenburg{at}lumc.nl

Background: Osteoarthritis of the hands is a prevalent musculoskeletal disease with a considerable effect on patients’ lives, but knowledge and research results in the field of hand osteoarthritis are limited. Therefore, the Disease Characteristics in Hand OA (DICHOA) initiative was founded in early 2005 with the aim of addressing key issues and facilitating research into hand osteoarthritis.

Objective: To review and discuss current knowledge on hand osteoarthritis with regard to aetiopathogenesis, diagnostic criteria, biomarkers and clinical outcome measures.

Methods: Recommendations were made based on a literature review.

Results: Outcomes of hand osteoarthritis should be explored, including patient perspective on the separate components of disease activity, damage and functioning. All imaging techniques should be cross-validated for hand osteoarthritis with clinical status, including disease activity, function and performance, biomarkers and long-term outcome. New imaging modalities are available and need scoring systems and validation. The role of biomarkers in hand osteoarthritis has to be defined.

Conclusion: Future research in hand osteoarthritis is warranted.

Abbreviations: ACR, American College of Rheumatology; AUSCAN, Australian/Canadian Osteoarthritis Hand Index; CMC, carpometacarpal joints; DICHOA, Disease Characteristics in Hand OA; DIP, distal interphalangeal joint; MCP, metacarpophalangeal joints; PIP, proximal interphalangeal joint; SACRAH, Score for the Assessment and Quantification of Chronic Rheumatoid Affections of the Hands

Keywords: osteoarthritis; hand; outcome measures; biomarkers; imaging

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