title: Aesthetic discomfort in hand osteoarthritis: results from the LIège Hand Osteoarthritis Cohort (LIHOC).
abstract: BACKGROUND
  The primary complaint of patients with hand osteoarthritis (OA) is frequently the inelegant appearance of their hands. Only one study has been conducted to assess the magnitude of and identify the determinants of aesthetic discomfort in hand OA.
  
  
  METHODS
  The LIège Hand Osteoarthritis Cohort is a prospective cohort of 203 patients diagnosed with hand OA. At baseline, these patients rated their aesthetic discomfort on a 100-mm visual analogue scale (VAS) and used a Likert scale (range 0-7) to quantify the magnitude of their aesthetic damage.
  
  
  RESULTS
  The median value of the aesthetic discomfort VAS was 35.0 [interquartile range (Q1-Q3) 6.0-59.0]. The median damage was rated 3.0 (Q1-Q3 1.0-4.0), corresponding to a moderate level. Both were significantly (p < 0.02) associated with the female gender, the duration of hand OA, the radiological severity of OA (Verbruggen-Veys and Kellgren-Lawrence scales) and pain, disability, or stiffness [Australian Canadian Osteoarthritis Hand Index (AUSCAN) and Functional Index for Hand Osteoarthritis ]. After a stepwise analysis, the parameters correlated to the aesthetic discomfort were the presence of erosive joints (p = 0.0048), the AUSCAN score (p < 0.0001), the number of joints with severe radiological damage (p = 0.023), and gender (p = 0.0009). For aesthetic damage, the parameters associated were AUSCAN score (p < 0.0001), duration of hand OA >10 years (p = 0.001), and presence of erosive joints (p < 0.0001). Compared with patients with low aesthetic discomfort (VAS ≤33 mm), those with the highest discomfort (VAS ≥66 mm) had more erosive OA (p = 0.014), a higher Verbruggen and Veys score (p = 0.0039), and a higher AUSCAN score (p < 0.001).
  
  
  CONCLUSIONS
  Aesthetic discomfort and damage are significant complaints in patients with hand OA. The determinants of the magnitude of these are gender, radiological severity, duration of hand OA, presence of erosive joints, and impact on pain, function, and stiffness as assessed with the AUSCAN.
authors.affiliation: Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium. audrey.neuprez@chu.ulg.ac.be.
authors.forename: Audrey
authors.initials: A
authors.lastname: Neuprez
authors.affiliation: Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium. olivier.bruyere@ulg.ac.be.
authors.forename: Olivier
authors.initials: O
authors.lastname: Bruyère
authors.affiliation: Department of Rheumatology, AP-HP, St. Antoine Hospital, Paris, France. emaheu@wanadoo.fr.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Maheu
authors.affiliation: Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium. ndardenne@ulg.ac.be.
authors.forename: Nadia
authors.initials: N
authors.lastname: Dardenne
authors.affiliation: Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium. nansaburlet@gmail.com.
authors.forename: Nansa
authors.initials: N
authors.lastname: Burlet
authors.affiliation: Department of Orthopaedics and Sports Medicine, Aspetar Hospital, Doha, Qatar. pieter.orthopedie@gmail.com.
authors.forename: Pieter
authors.initials: P
authors.lastname: D'Hooghe
authors.affiliation: Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium. s.disteche@skynet.be.
authors.forename: Stéphan
authors.initials: S
authors.lastname: Distèche
authors.affiliation: Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium. jyreginster@ulg.ac.be.
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Reginster
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D004185:Disability Evaluation; D004954:Esthetics / Q000523:psychology; D005260:Female; D005384:Finger Joint / Q000473:pathology / Q000503:physiopathology*; D050823:Hand Joints / Q000473:pathology / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000473:pathology / Q000503:physiopathology* / Q000523:psychology; D010146:Pain / Q000473:pathology / Q000503:physiopathology*; D010147:Pain Measurement; D011446:Prospective Studies; D012044:Regression Analysis; D012720:Severity of Illness Index