Hand Osteoarthritis in Elderly Women with Primary Knee Osteoarthritis: Prevalence and Pattern in the Indian Population

Abstract

Aim: The aim of this study was to estimate prevalence of hand osteoarthritis (HOA) and identify patterns in female patients with symptomatic primary knee osteoarthritis (KOA) presenting in a rheumatology outpatient department (OPD). Methods: A hospital-based cross-sectional study was done among 145 female patients with primary KOA, as per American College of Rheumatology (ACR) criteria, utilising the right knee as the index knee. The presence of Kellgren–Lawrence (K-L) grade ≥2 radiological changes in two of three groups of hand joints in dominant hand was used to identify hand arthritis (HOA). Symptomatic HOA (SHOA) was defined as existence of hand discomfort within preceding month. Hand disability was measured using the Health Assessment Questionnaire (HAQ); a mean score of >0.5 was deemed to be a significant disability. Global Hand Kellgren–Lawrence Score (KLTOT) was used to assess radiographic severity of HOA. Results: The prevalence of HOA was found in 96 (66%) patients, with a higher prevalence in patients above 60 years of age. At the individual joint level, 102 (71.7%) patients had DIP involvement, 96 (66.2%) had PIP involvement, 40 (27.5%) had metacarpophalangeal (MCP) involvement, and 57 (34.4%) had involvement in the base of the thumb. SHOA was found in 48 (33%) patients, and significant disability was noted in 38 (26.2%) patients. There was a significant positive correlation between global KLTOT and body mass index (BMI) ( P = .004) and between global KLTOT and HAQ ( P = .002). A significant difference was found between HOA and the radiographic severity of the KOA ( P = .003) in comparison to patients without HOA. Conclusion: HOA is common in elderly women, especially those with primary KOA.