Objective: To investigate the prevalence and pattern of radiographic osteoarthritis (ROA) of the hand joints and its association with self reported hand pain and disability. Methods: Baseline data on a population based study (age >55 years) were used (n = 3906). Hand ROA was defined as the presence of Kellgren-Lawrence grade >2 radiological changes in two of three groups of hand joints in each hand. The presence of hand pain during the previous month was defined as hand pain. The health assessment questionnaire was used to measure hand disability. Results: 67% of the women and 54.8% of the men had ROA in at least one hand joint. DIP joints were affected in 47.3% of participants, thumb base in 35.8%, PIP joints in 18.2%, and MCP joints in 8.2% (right or left hand). ROA of other joint groups (right hand) co-occurred in 56% of DIP involvement, 88% of PIP involvement, 86% of MCP involvement, and 65% of thumb base involvement. Hand pain showed an odds ratio of 1.9 (1.5 to 2.4) with the ROA of the hand (right). Hand disability showed an odds ratio of 1.5 (1.1 to 2.1) with ROA of the hand (right or left). Conclusions: Hand ROA is common in the elderly, especially in women. Co-occurrence of ROA in different joint groups of the hand is more common than single joint disease. There is a modest to weak association between ROA of the hand and hand pain/disability, varying with the site of involvement.

No intermediate effect of metabolic factors on the association of overweight with HOA was found. An increase in the prevalence of HOA, however, seems to be present when overweight occurs together with hypertension and diabetes especially at a relatively young age.

Objective: To study the prevalence of hand pain and hand disability in an open population, and the contribution of their potential determinants. Methods: Baseline data were used from 7983 participants in the Rotterdam study (a population based study in people aged >55 years). A home interview was used to determine the presence of hand pain during the previous month, rheumatoid arthritis, osteoarthritis in any joint, diabetes, stroke, thyroid disease, neck/shoulder pain, gout, history of fracture in the past five years, and Parkinson's disease, as well as age, sex, and occupation. Hand disability was defined as the mean score of eight questions related to hand function. Body mass index was measured and hand x rays were taken. Results: The one month period prevalence of hand pain was 16.9%. The prevalence of hand disability was 13.6%. In univariate analysis for hand pain, rheumatoid arthritis had the highest explained variance (R 2 ) and odds ratio. For hand disability, aging showed the highest explained variance and Parkinson's disease had the highest odds ratio. All determinants together showed an explained variance of 19.8% for hand pain and 25.2% for hand disability. In multivariate analysis, positive radiographic hand osteoarthritis was a poor explanation for hand pain (R 2 = 0.5%) or hand disability (R 2 = 0). Conclusions: The contribution of available potential determinants in this study was about 20% for hand pain and 25% for hand disability in an unselected population of elderly people. Thus a greater part of hand pain/hand disability remains unexplained.T he life expectancy in western societies has increased over the last decades. However, many people reach old age with increasing chronic pain and disability. In a recent United Kingdom survey, the incidence of self reported pain was 50%, or 46.5% when adjusted to the whole UK population. 1 The three most common causes of chronic pain are musculoskeletal disorders, neuropathic disorders, and tumours. The estimated prevalence of distal upper limb pain varies depending on the severity and duration of the symptoms. The reported prevalence of hand or wrist pain varies between 3% and 26% of the general population. [3][4][5] Disability is reflected in difficulties in performing activities of daily living, of which hand function is an important aspect. The ability to use the hand effectively depends on anatomical integrity, mobility, muscle strength, sensation, coordination, and absence of pain.6-8 Although chronic pain and disability have received much attention, less is known about hand pain and hand disability specifically. To achieve effective management of pain and disability in the hand, the potential determinants need to be understood. Rheumatoid arthritis, other types of chronic arthritis, osteoarthritis, carpal tunnel syndrome, different forms of tendinitis in the hand and wrist, referred pain from the neck or shoulder, diabetes, other peripheral neuropathies, fractures in the hand and wrist, fibromyalgia, stroke, thyroid disease, gout, Parkinson's dise...

Objective. To evaluate the risk of future hip or knee osteoarthritis (OA) in subjects with hand OA at baseline and to evaluate whether the concurrent presence of hand OA, other risk factors for OA, or an OA biomarker (type II collagen C-telopeptide degradation product [CTX-II]) further increases the risk.Methods. Radiographs of the hands (baseline) and the hips and knees (baseline and 6.6 years later) were obtained in a randomly selected subset of participants in the Rotterdam Study who were ages 55 years and older. Radiographs were scored for the presence of OA using the Kellgren/Lawrence (K/L) system. A total of 1,235 subjects without OA of the hip/knee (K/L score 0-1) at baseline were included in the study. CTX-II levels were measured at baseline. The independent risk of future hip/knee OA in subjects with hand OA at baseline was assessed by logistic regression, as stratified for age, sex, body mass index, family history of OA, and heavy workload. Conclusion. The presence of hand OA at baseline showed an increased risk of future hip/knee OA (higher for hip OA than for knee OA). The concurrent presence of hand OA and other OA risk factors or high CTX-II levels further increased the risk of future hip/knee OA.Osteoarthritis (OA) is the most common form of arthritis among the elderly and a leading musculoskeletal cause of disability in Western countries (1,2). Due partly to the length of working careers, the substantial prevalence of OA in middle-aged people causes the loss of much working time to illness (3). In terms of pain, disability, and cost, the clinical and societal impact of OA of the weight-bearing joints (i.e., the hips and knees) is greater than that of hand OA (1).It has been suggested that generalized OA may be a distinct disease in which systemic (genetic) predisposition is more important than local (mechanical) factors (1,4). A recent postmortem bone study confirmed the hypothesis that OA is caused primarily by a systemic predisposition to a certain type of bone response to mechanical stresses (5). Hand, hip, and knee OA are thus based partly on a systemic predisposition. While clinically less relevant, the presence of hand OA may therefore predict the more disabling hip or knee OA later in life.Although other cross-sectional studies have addressed the association of hand OA with hip or knee OA (6-10), we know of only 1 study that has examined the link between hand OA earlier in life and knee OA later on (11). No study has evaluated the association between hand OA earlier in life and the occurrence of hip OA later on. By identifying subjects who have a tendency for developing OA and by modifying their risk factors, it

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