Abstract

Osteoarthritis of the interphalangeal finger joints constitutes one of the most prevalent musculoskeletal diseases with variable clinical impact ranging from nearly asymptomatic to severe inflammatory pain in and around affected joints, presence of soft tissue and bony swelling, stiffness and gradual loss of function. Current therapeutic options are limited to analgesic treatment but research on targeted therapies is increasing.

In order to improve the current treatments, a critical appraisal of the needs for improvement in finger OA is needed and how disease activity is best defined.

Assessing disease activity or joint activity in finger OA is challenging: disease activity can comprise pain, inflammatory activity and structural damage.

In clinical practice, a combination of patient-reported (e.g. visual analogue scale or Likert scale pain), more objective and performance-based measures (e.g. grip strength) are used to assess and follow disease activity. In clinical research, pharmacological trials and epidemiological studies, a standardized approach to assess the disease activity is necessary to estimate the burden of disease and to evaluate the efficacy of potential new treatments. The instruments being used, depend mostly on the aim of the study or research question. In case structural disease progression is being studied, imaging-based outcome measures are mostly used. Structural changes can be assessed on joint level or on patient level, both by conventional radiographs, ultrasound and magnetic resonance imaging. Several imaging based outcome measures and scoring systems are being suggested but true consensus about the instruments of preference is still lacking. Therefore, further validation of these instruments is warranted.

This lecture will give an overview of the current instruments to measure activity in finger OA in several domains and discuss its strengths and limitations.