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Research in hand osteoarthritis: time for reappraisal and demand for new strategies. An opinion paper
  1. Margreet Kloppenburg1,
  2. Tanja Stamm2,
  3. Iain Watt3,
  4. Franz Kainberger4,
  5. Tim E Cawston5,
  6. Fraser N Birrell5,
  7. Ingemar F Petersson6,7,
  8. Tore Saxne7,
  9. Tore K Kvien8,
  10. Barbara Slatkowsky-Christensen8,
  11. Maxime Dougados9,
  12. Laure Gossec9,
  13. Ferdinand C Breedveld1,
  14. Josef S Smolen2
  1. 1Leiden University Medical Center, Department of Rheumatology, The Netherlands
  2. 2Medical University of Vienna, Department of Internal Medicine III, Division of Rheumatology, Austria
  3. 3Leiden University Medical Center, Department of Radiology, The Netherlands
  4. 4Medical University of Vienna, Department of Radiology, Austria
  5. 5School of Clinical Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
  6. 6Spenshult Hospital for Rheumatic Diseases, Oskarström, Sweden
  7. 7Lund University Hospital, Department of Rheumatology, Lund, Sweden
  8. 8Diakonhjemmet Hospital, Department of Rheumatology, Oslo, Norway
  9. 9René-Descartes University, Medicine Faculty; APHP, Cochin Hospital, Rheumatology B Department, Paris, France
  1. Correspondence to:
    Margreet Kloppenburg
    MD PhD, Department of Rheumatology, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands; g.kloppenburg{at}


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.

  • 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
  • osteoarthritis
  • hand
  • outcome measures
  • biomarkers
  • imaging

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  • * The 10 selected hand joints include bilateral second and third DIP joints, second and third proximal interphalangeal joints and first carpometacarpal joints.

  • Published Online First 14 March 2007

  • The DICHOA meeting was supported by an unrestricted educational grant from MSD. No representative of the company participated in the meeting.