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New classification criteria for hand osteoarthritis

Researchers have developed new classification criteria for hand osteoarthritis with the support of the European Alliance of Associations for Rheumatology (EULAR). The new criteria combine self-reported data with radiological findings and represent a significant advance for all research within hand osteoarthritis.

New classification criteria IDA copy webIda K. Bos-Haugen has led the work on the new classification criteria for hand osteoarthritis. Photo: Diakonhjemmet hospital, Kathrine Daniloff

Hand osteoarthritis is a common condition that particularly affects the joints of the fingers and the root joint of the thumb, leading to pain and stiffness. Despite the fact that the condition is very widespread, there is no disease-modifying treatment for hand osteoarthritis. Now the international research team has developed new classification criteria that can be used in future research studies and thus promote good research into hand osteoarthritis.

- This is a step forward for patients with hand osteoarthritis, says Ida K. Bos-Haugen, the first author of the study. The new criteria enable us to classify hand osteoarthritis more precisely, both in intervention studies and in observational studies.

Advantages of new criteria

Until now, hand osteoarthritis has been classified using the American College of Rheumatology (ACR) criteria, which were developed over 30 years ago. These have been based on self-reported data and clinical joint examination, which can be difficult to conduct reliably, especially in large population studies.

- An advantage of the new criteria is that hand osteoarthritis can be classified using self-reported data and X-ray findings, and does not require a clinical examination, says Haugen. - Another major advantage is that the new criteria give us the opportunity to classify arthrosis in the finger joints and arthrosis in the root joint of the thumb separately, as these are two types of arthrosis that may require different approaches.

The development of new criteria

This work was led by senior researcher Ida K. Bos-Haugen at Diakonhjemmet hospital together with professor Margreet Kloppenburg (Leiden, the Netherlands) and professor David T. Felson (Boston, USA). Diakonhjemmet Sykehus was also well represented in the multidisciplinary expert panel where occupational therapist Merete Hermann-Eriksen and physiotherapist Rikke H. Moe participated.

The new criteria were developed through a process in three phases. In the first phase, the researchers identified symptoms and findings that could distinguish hand arthrosis from other conditions that cause pain in the hands. In the second phase, they used a consensus-based decision analysis to assess the criteria's relative importance from a clinical perspective. In the third phase, the scoring system was fine-tuned, the cut-off values ​​for disease classification were determined, and the new criteria were compared with the existing criteria from the ACR.

- We now have the opportunity to classify hand osteoarthritis based on a combination of age, duration of morning stiffness, number of joints with bony deposits and joint space narrowing on X-ray, as well as correspondence between symptoms and X-ray findings, explains Haugen. By using these criteria, one will identify people who are highly likely to have symptoms from the hands due to hand osteoarthritis, which is precisely what is desired in clinical studies.

The future of hand osteoarthritis research

The new criteria are intended for use in research, and not in clinical practice. The aim of the criteria is to contribute to better research into hand osteoarthritis.

- Our work gives hope that we can carry out better studies that will one day lead to better treatment for everyone who suffers from this painful condition, concludes Haugen.

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