Stéphan Distèche

Assessment and determinants of aesthetic discomfort in hand osteoarthritis

Background Dissatisfaction with hand appearance is frequently the presenting complaint of patients with hand osteoarthritis (HOA), yet no tool exists for its measurement and few studies have examined aesthetic discomfort. Objectives The aims of this study were to measure the extent and to explore the associations of aesthetic concerns in HOA. Methods 172 patients with HOA were assessed with tender joint and node count, global and pain scores, Functional Index for Hand Osteoarthritis, Short Form-12, Hospital Anxiety and Depression Scale and posterior–anterior hand radiographs. Patients scored the aesthetic impact of the disease on a Visual Analogue Scale of 0–100 mm and were classifi ed into low, intermediate and high aesthetic concern (HAC) based on this score. Results Of 172 patients (155 women), the majority (92%) had nodes and 46% had erosive disease. The mean aesthetic score was 44.8 mm (SD 35.9), and 59 (34.3%) patients scored their aesthetic discomfort ≥66 mm. Factors associated with HAC were female gender, a high number of tender joints and nodes, high global and pain scores, high radiological damage scores, the presence of erosions and high depression and anxiety levels. The multivariate analysis identifi ed two independent factors associated with HAC: patient’s global assessment (p=0.0005) and radiographic erosions (p=0.03). Conclusions Aesthetic discomfort is a major concern for a signifi cant number of patients with HOA, particularly women, those with a high burden of HOA disease and those with erosive osteoarthritis, and is also associated with depression, anxiety and poor health-related quality of life.

Additional file 2: Table S2. of Aesthetic discomfort in hand osteoarthritis: results from the LIège Hand Osteoarthritis Cohort (LIHOC)

Characteristics of patients reporting high (HAD) or low (LAD) (aesthetic discomfort). (DOC 55 kb)

Baseline characteristics of the Liège Hand Osteoarthritis Cohort (LIHOC)

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. Objectives To better understand the impact of hand osteoarthritis on quality of life and health resources utilization of interdigital osteoarthritis. Methods We decided to prospectively follow a cohort of 203 individuals, diagnosed with hand OA during consultations held at a tertiary care facility specialized in bone and cartilage metabolism and called the Liège Hand Osteoarthritis Cohort (LIHOC). Results As expected, the vast majority of patients (90.1%) were of female gender with 46.8% having a family history of hand OA. The median age of the population was 69.1 years (Q1 61.9-Q3 75.6). Body Mass Index (kg/m2) median was 25.6 (22.9-28.9). Hand OA was associated with other joint involvement in 87.1% of the cases {mainly spine (70.8%) and knee (69.0%)}. On a Visual Analog Scale reflecting pain in hand joints, graded from 0 to 100, the median score was 50.0 (29.0-59.0), with a median number of painful joints at pressure of 5.0 (2.0-10.0). The median number of swollen joints and of joint with bony deformations was respectively 2.0 (1.0-4.0) and 10.0 (6.0-15.0). The total normalized Auscan score (0-300) median value was 129.0 (71.1-182.5) while the median Functional Index for Hand Osteoarthritis (FIHOA) score (0-30) was 5.0 (2.0-11.0). Radiologic assessment of hand OA showed a Verbruggen total score (0-218) median value of 31.6 (20.9-48.2) whereas the Kellgren-Lawrence total score (0-128) median value was 54.0 (40.0-66.0). Conclusions The LIHOC will be followed for a total duration of 5 years, with the objective to better understand the determinants of clinical and radiologic progression as well as the impact of hand OA on quality of life and health resources utilization. Disclosure of Interest None declared