Background Whereas hand osteoarthritis (OA) is a frequent disease, which may lead to considerable pain and physical limitations, limited research has been performed, compared to lower limbs OA. The primary complaint of patients is frequently related to the disgracious appearance of their hand joints. However, few studies have been conducted to identify the magnitude and the determinants of aesthetic discomfort in hand OA.
Objectives The LIège Hand Osteoarthritis Cohort (LIHOC) is a prospective cohort of 203 patients diagnosed with hand OA which are prospectively followed to better understand the impact of hand OA on quality of life and health resources utilization.
Methods At baseline, these patients were asked to rate their aesthetic discomfort related to hand OA on a 100 mm Visual Analog Scale and also use a seven-point Likert scale (0-7), commonly used in forensic medicine, to quantify the magnitude of their aesthetic damage.
Results The median value of the aesthetic discomfort VAS was 35.0 (Q1: 6.0-Q3: 59.0). Correlation analyses were performed between these scorings and clinical hand parameters. The median damage was rated at 3.0 (1.0-4.0), corresponding to a “moderate” level. Aesthetic discomfort (VAS) and the magnitude of the aesthetic damage (Likert) were significantly (p<0.02) correlated with the gender of the patients, the duration since the diagnosis of hand OA, the radiological assessment using the Verbruggen and Kellgren-Lawrence scales, the Australian Canadian Osteoarthritis Hand Index (AUSCAN), assessing the three dimensions of pain, disability and joint stiffness, of hand function based on the Functional Index for Hand Osteoarthritis (FIHOA), the spontaneously recorded global pain (VAS) and the number of joints presenting with erosive or severe lesions, bony deformations or the number of articulations, spontaneously reported as painful (Likert only) or painful at pressure. However, when a stepwise analysis procedure was applied, the only parameters which remained significantly correlated to the aesthetic discomfort were the number of erosive joints (p<0.0001) the total AUSCAN score (p<0.0001) and the gender of the patients (p=0.0026). For the assessment of aesthetic damage, the parameters which remained significantly associated were the AUSCAN total score (p<0.0001), a duration of hand OA above the 10 years (p=0.01) and the number of erosive joints (p<0.0001).
Conclusions Aesthetic discomfort and aesthetic damage are significant complaints in patients presenting with hand OA. The major determinants of their impact are gender, duration of hand OA, number of erosive joints and the Australian Canadian Osteoarthritis Hand Index.
Disclosure of Interest None declared