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Thumb base involvement in symptomatic hand osteoarthritis is associated with more pain and functional disability
  1. Jessica Bijsterbosch1,
  2. Willemien Visser1,
  3. Herman M Kroon2,
  4. Tanja Stamm3,
  5. Ingrid Meulenbelt4,
  6. Tom W J Huizinga1,
  7. Margreet Kloppenburg1
  1. 1Department of Rheumatology, Leiden University Medical Centre, Leiden, The Netherlands
  2. 2Department of Radiology, Leiden University Medical Centre, Leiden, The Netherlands
  3. 3Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna, Vienna, Austria
  4. 4Department of Molecular Epidemiology, Leiden University Medical Centre, Leiden, the Netherlands
  1. Correspondence to Jessica Bijsterbosch, Leiden University Medical Centre, Department of Rheumatology, C1-R, PO Box 9600, 2300 RC Leiden, The Netherlands; j.bijsterbosch{at}


Objective To assess the impact of different subsets of symptomatic hand osteoarthritis (OA) on pain and disability.

Methods From 308 patients with hand OA a group with carpometacarpal joint (CMCJ) symptoms only (group I, n=20) was identified as well as groups with symptoms at the interphalangeal joints (IPJs) only (group II, n=138), and symptoms at both sites (group III, n=150). Hand pain and function, assessed with the AUSCAN, were compared between groups using linear mixed models. Radiological OA was assessed using the Kellgren–Lawrence grading scale.

Results Mean (SD) AUSCAN scores for groups I, II and III were 23.1 (11.7), 18.3 (11.9) and 26.4 (12.5), respectively. After adjustment for age, gender, body mass index, family effects and number of symptomatic hand joints, significant differences in AUSCAN scores of 7.4 (95% CI 1.8 to 13.0) between groups I and II, and 5.7 (95% CI 2.7 to 8.6) between groups II and III were found. AUSCAN scores were 5.8 (95% CI 3.1 to 8.6) higher for patients with versus patients without CMCJ symptoms. Kellgren–Lawrence scores did not differ between groups.

Conclusion In symptomatic hand OA, CMCJ OA contributes more to pain and disability than IPJ OA. Hence, treatment of CMCJ OA should be emphasised, even if it coincides with IPJ OA.

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  • Funding The GARP study was supported by Pfizer Inc, Groton, Connecticut, USA and the Dutch Arthritis Association.

  • Ethics approval This study was conducted with the approval of the medical ethics committee of the Leiden University Medical Centre.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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