title: Thumb base involvement in symptomatic hand osteoarthritis is associated with more pain and functional disability.
abstract: OBJECTIVE
  To assess the impact of different subsets of symptomatic hand osteoarthritis (OA) on pain and disability.
  
  
  METHODS
  From 308 patients with hand OA a group with carpometacarpal joint (CMCJ) symptoms only (group I, n=20) was identified as well as groups with symptoms at the interphalangeal joints (IPJs) only (group II, n=138), and symptoms at both sites (group III, n=150). Hand pain and function, assessed with the AUSCAN, were compared between groups using linear mixed models. Radiological OA was assessed using the Kellgren-Lawrence grading scale.
  
  
  RESULTS
  Mean (SD) AUSCAN scores for groups I, II and III were 23.1 (11.7), 18.3 (11.9) and 26.4 (12.5), respectively. After adjustment for age, gender, body mass index, family effects and number of symptomatic hand joints, significant differences in AUSCAN scores of 7.4 (95% CI 1.8 to 13.0) between groups I and II, and 5.7 (95% CI 2.7 to 8.6) between groups II and III were found. AUSCAN scores were 5.8 (95% CI 3.1 to 8.6) higher for patients with versus patients without CMCJ symptoms. Kellgren-Lawrence scores did not differ between groups.
  
  
  CONCLUSIONS
  In symptomatic hand OA, CMCJ OA contributes more to pain and disability than IPJ OA. Hence, treatment of CMCJ OA should be emphasised, even if it coincides with IPJ OA.
authors.affiliation: Department of Rheumatology, Leiden University Medical Centre, Leiden, The Netherlands. j.bijsterbosch@lumc.nl
authors.forename: Jessica
authors.initials: J
authors.lastname: Bijsterbosch
authors.forename: Willemien
authors.initials: W
authors.lastname: Visser
authors.forename: Herman M
authors.initials: HM
authors.lastname: Kroon
authors.forename: Tanja
authors.initials: T
authors.lastname: Stamm
authors.forename: Ingrid
authors.initials: I
authors.lastname: Meulenbelt
authors.forename: Tom W J
authors.initials: TW
authors.lastname: Huizinga
authors.forename: Margreet
authors.initials: M
authors.lastname: Kloppenburg
mesh_terms: D018771:Arthralgia / Q000000981:diagnostic imaging / Q000503:physiopathology*; D052737:Carpometacarpal Joints / Q000000981:diagnostic imaging / Q000503:physiopathology*; D015331:Cohort Studies; D004185:Disability Evaluation; D005260:Female; D005384:Finger Joint / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000000981:diagnostic imaging / Q000503:physiopathology*; D010147:Pain Measurement; D011859:Radiography; D013933:Thumb / Q000000981:diagnostic imaging / Q000503:physiopathology*