Clinical characteristics of an anatomical hand index measured in patients with rheumatoid arthritis as a potential outcome measure.
OBJECTIVE
To determine the clinical characteristics of an anatomical hand index previously reported as a potential measure of joint deformity and outcome in patients with rheumatoid arthritis.


METHODS
The hand index (open hand span - closed hand span/lateral height of the hand) was measured in a cross-sectional study of 145 out-patients with rheumatoid arthritis with disease durations 0-55 yr. Subsets of patients were restudied at mean follow-ups of approximately 9 months and 4 yr.


RESULTS
The hand index fell gradually with disease duration. Correlations were demonstrated with the Sharp index (r = - 0.39, P = 0.000) and to a lesser extent with disease activity score (r = - 0.28, P = 0.001). At 260 +/- 115 days the hand index worsened by 0.09 units (P = 0.09, NS). At 51.6 +/- 5.4 months the index showed a fall from 1.96 +/- 0.73 to 1.61 +/- 0.65 (P = 0.000). During the same interval the Sharp index increased from 60 +/- 68 to 80 +/- 71 (P = 0.000).


CONCLUSIONS
Measurement of simple hand dimensions can demonstrate worsening of hand deformity with time in patients with rheumatoid arthritis. We suggest that more sophisticated analysis of digital hand images, as used in our original study, might yield additional information and increase the sensitivity of an anatomical hand index as an outcome measure in rheumatoid arthritis.
Highton
J
J
Department of Medicine, Dunedin School of Medicine, University of Otago, P. O. Box 913, Dunedin, New Zealand. john.highton@stonebow.otago.ac.nz
Markham
V
V
Doyle
T C A
TC
Davidson
P L
PL
D000886:Anthropometry / Q000379:methods; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000473:pathology*; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006225:Hand / Q000473:pathology*; D006227:Hand Deformities, Acquired / Q000175:diagnosis / Q000209:etiology / Q000473:pathology*; D006801:Humans; D007834:Lasers; D008297:Male; D017063:Outcome Assessment, Health Care; D012720:Severity of Illness Index