title: Disease impact of hand OA compared with hip, knee and generalized disease in specialist rheumatology health care.
abstract: OBJECTIVE
  To describe and compare disease impact in patients with hand OA with those with hip, knee and generalized disease.
  
  
  METHODS
  Patients with OA referred to a specialized rheumatology clinic (408 patients, 86% women) were included in a cross-sectional study. They were examined by a rheumatologist and classified into primary hand, hip, knee and/or generalized (more than two joint localizations) OA. Patient-reported disease impact was collected on numeric rating scales (pain, fatigue), Hopkins Symptom Checklist-25 (emotional distress), Western Ontario and McMaster and Australian/Canadian Hand OA indexes (disease-specific functioning), Short Form 36 (generic health-related quality of life) and a comorbidity checklist.
  
  
  RESULTS
  Considerable disease impact was detected across all localizations: patients scored >5 on pain (range 0-10), had on average two comorbidities and scored >1.5 on emotional distress (Hopkins Symptom Checklist-25, range 1-4). Patients with hand OA scored poor on disease-specific functioning of the lower extremities, and patients with lower extremity OA also scored poor on disease-specific hand functioning. Patients with hand OA scored better on pain (P = 0.001, one-way analyses of variance) and the Short Form 36 Health Survey physical component (P < 0.001), whereas no major differences were observed for the mental component (P = 0.07).
  
  
  CONCLUSIONS
  OA patients referred to specialist care reported considerable levels of disease impact across localizations. Regardless of functional impairments related to the primary OA localization, patients generally reported high levels of impaired disease-specific functioning at other sites. In the management of OA clinicians should also consider functioning in joint sites other than the primary OA localization. Trial registration. Current controlled trials, www.controlled-trials.com, ISRCTN25778426.
authors.affiliation: Department of Rheumatology, National Resource Center for Rehabilitation in Rheumatology (NRRK), Diakonhjemmet Hospital, PO Box 23, Vinderen, No-0319 Oslo. tomogrikke@c2i.net
authors.forename: Rikke H
authors.initials: RH
authors.lastname: Moe
authors.forename: Margreth
authors.initials: M
authors.lastname: Grotle
authors.forename: Ingvild
authors.initials: I
authors.lastname: Kjeken
authors.forename: Kåre B
authors.initials: KB
authors.lastname: Hagen
authors.forename: Tore K
authors.initials: TK
authors.lastname: Kvien
authors.forename: Till
authors.initials: T
authors.lastname: Uhlig
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D050823:Hand Joints / Q000503:physiopathology*; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D010147:Pain Measurement; D011788:Quality of Life; D011795:Surveys and Questionnaires