Hand osteoarthritis: clinical phenotypes, molecular mechanisms and disease management

Osteoarthritis (OA) is a highly prevalent condition and the hand is the most commonly affected site. Patients with hand OA frequently report symptoms of pain, functional limitations, and frustration in undertaking everyday activities. The condition presents clinically with changes to the bone, ligaments, cartilage and synovial tissue, which can be observed using radiography, ultrasonography or MRI. Hand OA is a heterogeneous disorder and is considered to be multifactorial in aetiology. This review provides an overview of the epidemiology, presentation and burden of hand OA, including an update on hand OA imaging (including the development of novel techniques), disease mechanisms and management. In particular, areas for which new evidence has substantially changed the way we understand, consider and treat hand OA are highlighted. For example, genetic studies, clinical trials and careful prospective imaging studies from the past 5 years are beginning to provide insights into the pathogenesis of hand OA that might uncover new therapeutic targets in disease

PROMs for osteoarthritis

Osteoarthritis (OA) is the most common rheumatic disease, most often affecting the knee, hip, and hand joints. Patient-reported outcome measures (PROMs) play an important role in the management of patients with OA. Because OA can occur in people across all ages of the lifespan, clinicians should select PROMs that are able to capture the course of the disease, from early to end-stage joint disease. PROMs are also useful to monitor treatment effectiveness. This chapter explores why it is important to use PROMs for patients with OA and highlights attributes that make a “good” PROM for clinical use in patients with OA. We present a detailed summary of a selected group of PROMs for knee, hip, and hand OA regarding the evidence for their measurement properties, as well as considerations when applying each PROM in clinical practice. The chapter concludes by listing PROMs that can be used in other joints affected by OA