Background Osteoarthritis is the most common joint disease with the highest prevalence of hand osteoarthritis (HOA). According to various sources, the age of onset of the disease accounts for 45-47 years affecting 50% over 55 years, women suffer predominantly.
The main studied effects of HOA are loss of functioning and joint pain, but they do not reflect all aspects of health-related quality of life. One of the most frequent complaints is an aesthetic discomfort of patients, but it is not clear how to measure the same. Till now, there are no validated questionnaires allowing reliable measure of the level of aesthetic dissatisfaction.
Objectives To measure the extent of aesthetic discomfort in women with HOA in Russian Federation and to try to identify its causes
Methods 30 women of 45-75 years with HOA were included. The diagnosis met the American College of Diagnosis criteria of HOA. Demographic details included age, disease duration, menopausal status, body mass index (BMI). The number of painful and nodulus joints was assessed among 22 joints (DIP, PIP, IP-1, MCP-1 and CMC-1). Global patient`s assessment, joint pain in the hands, the most painful joint and the Australian/Canadian Osteoarthritis Hand Index (AUSCAN) were obtained using Visual Analogue Scale (VAS). In addition women were asked a few standardized questions to assess the extent of aesthetic dissatisfaction using VAS. Data were analyzed using Statistica 10.0 and are presented as mean (standard deviation).
Results The average age of the patients was 61.1(8.9) years, the duration of HOA 8.6 (6.4) years, BMI 25.6 (4.2). The number of painful joints was 4.5 (3.8), nodulus joints – 7.8 (4.6). General health assessment by VAS was 48.3 (21.5), joint pain – 32.5(19), the most painful joint – 43.8 (25.7).
In answering the question, “Do you feel anxiety because of deformation of your hands?” ) the responce according to 0-100 scale (0=no anxiety at all, 100=this is my main problem) was 38.9 (22.9). “Do you feel uncomfortable if your hands are visible (in the center of attention)?» - 38.3 (21.7). “How much do you worry about the deformation of your hands?» - 60.5 (28.9). “How much do you worry about the pain in your hands?» - 43.1 (25.1). Have you thought about the possibility of surgical correction of the deformity? » - 10.1 (8.1). “Are you afraid that the deformity will progress?» - 65.6 (17.0).
In analyzing the data joint pain assessing by VAS correlated with the level of anxiety of patients because of the deformity ( r= 0.74), and no relationship between pain and functioning was found. In assessing anxiety because of deformity it was related to the extent of fear of progression (r = 0.67) and the level of morning stiffness by AUSCAN (r = 0.75). Number of nodes had a moderate association (r = 0.69) with a desire to surgical correction and did not correlate with other indicators.
Conclusions All patients with osteoarthritis of hands marked anxiety about deformation of the same, which was closely associated with the presence of pain and not with the severity of functional impairment. There is a great need to develop a standardized questionnaire to measure the extent of aesthetic discomfort, to understand its causes and possible influence on the same. The work in this direction should be continued.
Disclosure of Interest None Declared
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