Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Hand osteoarthritis: clinical phenotypes, molecular mechanisms and disease management

Nature Reviews Rheumatology volume 14, pages 641–656 (2018)Cite this article

Subjects

Abstract

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 the disease.

Key points

  • Hand osteoarthritis (OA) is highly prevalent, and individuals with this condition frequently report symptoms of pain, functional limitations and frustration in undertaking everyday activities.

  • Clinical imaging is not recommended for the diagnosis or routine monitoring of patients with hand OA unless an alternative diagnosis is suspected.

  • MRI and ultrasonography findings have provided insight into hand OA pathology, but further prospective studies are required to inform on how features of the disease change over time.

  • Hand OA is multifactorial in aetiology with evidence for the involvement of abnormal mechanical loading and hereditary factors, whereas the contribution of inflammation to pathogenesis remains contentious.

  • Recommendations for core treatments in the management of hand OA should be integrated into clinical practice to improve the quality of care for patients.

  • A greater understanding of the presentation, pathogenesis and disease course is needed to help provide targeted therapy with existing and new treatments.

This is a preview of subscription content, access via your institution

Relevant articles

Open Access articles citing this article.

Access options

Rent or buy this article

Prices vary by article type

from$1.95

to$39.95

Learn more

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Features of hand osteoarthritis.
Fig. 2: Predicted molecular drivers of hand osteoarthritis by genetic association.

References

  1. Global Burden of Disease Study 2013 Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease study 2013. Lancet 386, 743–800 (2015).

    Google Scholar 

  2. Cross, M. et al. The global burden of hip and knee osteoarthritis: estimates from the global burden of disease 2010 study. Ann. Rheum. Dis. 73, 1323–1330 (2015).

    Google Scholar 

  3. Dziedzic, K. et al. The impact of musculoskeletal hand problems in older adults: findings from the North Staffordshire Osteoarthritis Project (NorStOP). Rheumatology (Oxford). 46, 963–967 (2007).

    CAS  PubMed  Google Scholar 

  4. Kloppenburg, M. & Kwok, W. Y. Hand osteoarthritis - a heterogeneous disorder. Nat. Rev. Rheumatol. 8, 22–31 (2011).

    PubMed  Google Scholar 

  5. Marshall, M. et al. Subsets of symptomatic hand osteoarthritis in community-dwelling older adults in the United Kingdom: prevalence, inter-relationships, risk factor profiles and clinical characteristics at baseline and 3-years. Osteoarthr. Cartil. 21, 1674–1684 (2013).

    CAS  PubMed  PubMed Central  Google Scholar 

  6. Kloppenburg, M. Hand osteoarthritis-nonpharmacological and pharmacological treatments. Nat. Rev. Rheumatol. 10, 242–251 (2014).

    CAS  PubMed  Google Scholar 

  7. EIT Health. Joint implementation of guidelines for oSteoArthritis in Western Europe (JIGSAW-E). EIT Health https://www.eithealth.eu/jigsaw-e (2018).

  8. National Institute for Health & Care Excellence. Osteoarthritis: care and management in adults. NICE https://www.nice.org.uk/guidance/cg177 (2014).

  9. National Institute for Health & Care Excellence. Osteoarthritis. NICE https://www.nice.org.uk/guidance/qs87 (2015).

  10. Dziedzic, K. S. et al. Self management, joint protection and exercises in hand osteoarthritis: a randomised controlled trial with cost effectiveness analyses. BMC Musculoskelet. Disord. 12, 156 (2011).

    PubMed  PubMed Central  Google Scholar 

  11. Altman, R. et al. The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hand. Arthritis Rheum. 33, 1601–1610 (1990).

    CAS  PubMed  Google Scholar 

  12. Marshall, M., Dziedzic, K. S., van der Windt, d.A. & Hay, E. M. A systematic search and narrative review of radiographic definitions of hand osteoarthritis in population-based studies. Osteoarthr. Cartil. 16, 219–226 (2008).

    CAS  PubMed  Google Scholar 

  13. Hammer, H. B. et al. Global ultrasound assessment of structural lesions in osteoarthritis: a reliability study by the OMERACT ultrasonography group on scoring cartilage and osteophytes in finger joints. Ann. Rheum. Dis. 75, 402–407 (2016).

    CAS  PubMed  Google Scholar 

  14. Srikanth, V. K. et al. A meta-analysis of sex differences prevalence, incidence and severity of osteoarthritis. Osteoarthr. Cartil. 13, 769–781 (2005).

    PubMed  Google Scholar 

  15. Punzin, L., Ramonda, R. & Sfriso, P. Erosive osteoarthritis. Best. Pract. Res. Clin. Rheumatol. 18, 739–758 (2004).

    Google Scholar 

  16. Pereira, D. et al. The effect of osteoarthritis definition on prevalence and incidence estimates: a systematic review. Osteoarthr. Cartil. 19, 1270–1285 (2011).

    CAS  PubMed  Google Scholar 

  17. Sowers, M., Lachance, L., Hochberg, M. & Jamadar, D. Radiographically defined osteoarthritis of the hand and knee in young and middle-aged African American and Caucasian women. Osteoarthr. Cartil. 8, 69–77 (2000).

    CAS  PubMed  Google Scholar 

  18. Kodama, R. et al. Prevalence of hand osteoarthritis and its relationship to hand pain and grip strength in Japan: the third survey of the ROAD study. Mod. Rheumatol. 26, 767–773 (2016).

    PubMed  Google Scholar 

  19. Davatchi, F. et al. Epidemiology of rheumatic diseases in Iran from analysis of four COPCORD studies. Int. J. Rheum. Dis. 19, 1056–1062 (2016).

    PubMed  Google Scholar 

  20. Zhang, Y. et al. Lower prevalence of hand osteoarthritis among Chinese subjects in Beijing compared with white subjects in the United States: the Beijing Osteoarthritis study. Arthritis Rheum. 48, 1034–1040 (2003).

    PubMed  Google Scholar 

  21. Haugen, I. K. et al. Prevalence, incidence and progression of hand osteoarthritis in the general population: the Framingham Osteoarthritis study. Ann. Rheum. Dis. 70, 1581–1586 (2011).

    PubMed  Google Scholar 

  22. Tomi, A.-L. et al. Increased prevalence and severity of radiographic hand osteoarthritis in patients with HIV-1 infection associated with metabolic syndrome: data from the cross-sectional METAFIB-OA study. 75, 2101–2107 (2016).

  23. Qin, J. et al. Lifetime risk of symptomatic hand osteoarthritis: the Johnston County Osteoarthritis Project. Arthritis Rheumatol. 69, 1204–1212 (2017).

    PubMed  PubMed Central  Google Scholar 

  24. Kallman, D. A., Wigley, F. M., Scott Jr, W. W., Hochberg, M. C. & Tobin, J. D. The longitudinal course of hand osteoarthritis in a male population. Arthritis Rheum. 33, 1323–1332 (1990).

    CAS  PubMed  Google Scholar 

  25. Haugen, I. K., Magnusson, K., Turkiewicz, A. & Englund, M. The prevalence, incidence, and progression of hand osteoarthritis in relation to body mass index, smoking, and alcohol consumption. J. Rheumatol. 44, 1402–1409 (2017).

    PubMed  PubMed Central  Google Scholar 

  26. Oliveria, S. A., Felson, D. T., Reed, J. I., Cirillo, P. A. & Walker, A. M. Incidence of symptomatic hand, hip, and knee osteoarthritis among patients in a health maintenance organization. Arthritis Rheum. 38, 1134–1141 (1995).

    CAS  PubMed  Google Scholar 

  27. Prieto-Alhambra, D. et al. Incidence and risk factors for clinically diagnosed knee, hip and hand osteoarthritis: influences of age, gender and osteoarthritis affecting other joints. Ann. Rheum. Dis. 73, 1659–1664 (2014).

    PubMed  Google Scholar 

  28. Botha-Scheepers, S. A. et al. Influence of familial factors on radiologic disease progression over two years in siblings with osteoarthritis at multiple sites: a prospective longitudinal cohort study. Arthritis Rheum. 57, 626–632 (2007).

    PubMed  Google Scholar 

  29. Zhang, W. et al. EULAR evidence based recommendations for the management of hand osteoarthritis: report of a task force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). Ann. Rheum. Dis. 66, 377–388 (2007).

    CAS  PubMed  Google Scholar 

  30. Tan, A. L. et al. High-resolution magnetic resonance imaging for the assessment of hand osteoarthritis. Arthritis Rheum. 52, 2355–2365 (2005).

    PubMed  Google Scholar 

  31. Villafañe, J. H. & Valdes, K. Combined thumb abduction and index finger extension strength: a comparison of older adults with and without thumb carpometacarpal osteoarthritis. J. Manipulative. Physiol. Ther. 36, 238–244 (2013).

    PubMed  Google Scholar 

  32. Cantero-Téllez, R., Martín-Valero, R. & Cuesta-Vargas, A. Effect of muscle strength and pain on hand function in patients with trapeziometacarpal osteoarthritis. A cross-sectional study. Reumatol Clin. 11, 340–344 (2015).

    PubMed  Google Scholar 

  33. McQuillan, T. J., Kenney, D., Crisco, J. J., Weiss, A. P. & Ladd, A. L. Weaker functional pinch strength is associated with early thumb carpometacarpal osteoarthritis. Clin. Orthop. Relat. Res. 474, 557–561 (2016).

    PubMed  Google Scholar 

  34. Coughlan, M. J. et al. Reduction in cylindrical grasp strength is associated with early thumb carpometacarpal osteoarthritis. Clin. Orthop. Relat. Res. 475, 522–528 (2017).

    PubMed  Google Scholar 

  35. Mobargha, N., Ludwig, C., Ladd, A. L. & Hagert, E. Ultrastructure and innervation of thumb carpometacarpal ligaments in surgical patients with osteoarthritis. Clin. Orthop. Relat. Res. 472, 1146–1154 (2014).

    PubMed  Google Scholar 

  36. Mallinson, P. I., Tun, J. K., Farnell, R. D., Campbell, D. A. & Robinson, P. Osteoarthritis of the thumb carpometacarpal joint: correlation of ultrasound appearances to disability and treatment response. Clin. Radiol. 68, 461–465 (2013).

    CAS  PubMed  Google Scholar 

  37. Dumont, C. et al. Osteoarthritis of the carpometacarpal joint of the thumb: a new MR imaging technique for the standardized detection of relevant ligamental lesions. Skeletal Radiol. 43, 1411–1420 (2014).

    PubMed  Google Scholar 

  38. Merritt, M. M., Roddey, T. S., Costello, C. & Olson, S. Diagnostic value of clinical grind test for carpometacarpal osteoarthritis of the thumb. J. Hand Ther. 23, 261–267 (2010).

    PubMed  Google Scholar 

  39. Choa, R. M., Parviz, N. & Giele, H. P. A prospective case-control study to compare the sensitivity and specificity of the grind and traction-shift (subluxation-relocation) clinical tests in osteoarthritis of the thumb carpometacarpal joint. J. Hand Surg. Eur. 39, 282–285 (2014).

    CAS  Google Scholar 

  40. Rees, F. et al. Distribution of finger nodes and their association with underlying radiographic features of osteoarthritis. Arthritis Care. Res. (Hoboken). 64, 533–538 (2012).

    PubMed  Google Scholar 

  41. Thaper, A., Zhang, W., Wright, G. & Doherty, M. Relationship between Heberden’s nodes and underlying radiographic changes of osteoarthritis. Ann. Rheum. Dis. 64, 1214–1216 (2005).

    CAS  PubMed  PubMed Central  Google Scholar 

  42. Vlychou, M., Koutroumpas, A., Alexiou, I., Fezoulidis, I. & Sakkas, L. I. High-resolution ultrasonography and 3.0 T magnetic resonance imaging in erosive and nodal hand osteoarthritis: high frequency of erosions in nodal osteoarthritis. Clin. Rheumatol. 32, 755–762 (2013).

    PubMed  Google Scholar 

  43. Hodkinson, B., Maheu, E., Michon, M., Carrat, F. & Berenbaum, F. Assessment and determinants of aesthetic discomfort in hand osteoarthritis. Ann. Rheum. Dis. 71, 45–49 (2012).

    PubMed  Google Scholar 

  44. Altman, R. D. & Gold, G. E. Atlas of individual radiographic features in osteoarthritis, revised. Osteoarthr. Cartil. 15, A1–A56 (2007).

    PubMed  Google Scholar 

  45. Verbruggen, G. & Veys, E. M. Numerical scoring systems for the anatomic evolution of osteoarthritis of the finger joints. Arthritis Rheum. 39, 308–320 (1996).

    CAS  PubMed  Google Scholar 

  46. Marshall, M. et al. Erosive osteoarthritis: a more severe form of radiographic hand osteoarthritis rather than a distinct entity? Ann. Rheum. Dis. 74, 136–141 (2015).

    PubMed  Google Scholar 

  47. Addimanda, O. et al. Clinical and radiographic distribution of structural damage in erosive and nonerosive hand osteoarthritis. Arthritis Care. Res. (Hoboken). 64, 1046–1053 (2012).

    PubMed  Google Scholar 

  48. Kwok, W. Y. et al. The prevalence of erosive osteoarthritis in carpometacarpal joints and its clinical burden in symptomatic community-dwelling adults. Osteoarthr. Cartil. 22, 756–763 (2014).

    CAS  PubMed  PubMed Central  Google Scholar 

  49. Kwok, W. Y. et al. Comparison of clinical burden between patients with erosive hand osteoarthritis and inflammatory arthritis in symptomatic community-dwelling adults: the Keele clinical assessment studies. Rheumatology (Oxford). 52, 2260–2267 (2013).

    PubMed  PubMed Central  Google Scholar 

  50. Wittoek, R., Cruyssen, B. V. & Verbruggen, G. Predictors of functional impairment and pain in erosive osteoarthritis of the interphalangeal joints: comparison with controlled inflammatory arthritis. Arthritis Rheum. 64, 1430–1436 (2012).

    PubMed  Google Scholar 

  51. Kortekaas, M. C., Kwok, W. Y., Reijnierse, M., Huizinga, T. W. & Kloppenburg, M. In erosive hand osteoarthritis more inflammatory signs on ultrasound are found than in the rest of hand osteoarthritis. Ann. Rheum. Dis. 72, 930–934 (2013).

    PubMed  Google Scholar 

  52. Haugen, I. K. et al. Synovitis and radiographic progression in non-erosive and erosive hand osteoarthritis: is erosive hand osteoarthritis a separate inflammatory phenotype? Osteoarthr. Cartil. 24, 647–654 (2016).

    CAS  PubMed  Google Scholar 

  53. Bukhave, E. B. & Huniche, L. Activity problems in everyday life—patients’ perspectives of hand osteoarthritis: “try imagining what it would be like having no hands”. Disabil. Rehabil. 36, 1636–1643 (2014).

    PubMed  Google Scholar 

  54. Bukhave, E. B., la Cour, K. & Huniche, L. The meaning of activity and participation in everyday life when living with hand osteoarthritis. Scand. J. Occup. Ther. 21, 24–30 (2014).

    Google Scholar 

  55. van Schoor, N. M. et al. Impact of clinical osteoarthritis of the hip, knee and hand on self-rated health in six European countries: the European Project on OSteoArthritis. Qual. Life. Res. 25, 1423–1432 (2016).

    PubMed  Google Scholar 

  56. Hall, A. J. et al. Association between osteoarthritis and cardiovascular disease: systematic review and meta-analysis. Eur. J. Prev. Cardiol. 23, 938–946 (2016).

    PubMed  Google Scholar 

  57. Koutroumpas, A. et al. Erosive hand osteoarthritis is associated with subclinical atherosclerosis and endothelial dysfunction. Int. J. Biomed. Sci. 9, 217–223 (2013).

    PubMed  PubMed Central  Google Scholar 

  58. Jonsson, H. et al. Hand osteoarthritis in older women is associated with carotid and coronary atherosclerosis: the AGES Reykjavik study. Ann. Rheum. Dis. 68, 1696–1700 (2009).

    CAS  PubMed  Google Scholar 

  59. Courties, A. et al. Coronary heart disease is associated with a worse clinical outcome of hand osteoarthritis: a cross-sectional and longitudinal study. RMD Open 3, e000344 (2017).

    PubMed  PubMed Central  Google Scholar 

  60. Haugen, I. K. et al. Hand osteoarthritis in relation to mortality and incidence of cardiovascular disease: data from the Framingham Heart Study. Ann. Rheum. Dis. 74, 74–81 (2015).

    PubMed  Google Scholar 

  61. Kluzek, S. et al. Painful knee but not hand osteoarthritis is an independent predictor of mortality over 23 years follow-up of a population-based cohort of middle-aged women. Ann. Rheum. Dis. 75, 1749–1756 (2016).

    CAS  PubMed  Google Scholar 

  62. Liu, R. et al. Mortality in osteoarthritis patients. Scand. J. Rheumatol. 44, 70–73 (2015).

    CAS  PubMed  Google Scholar 

  63. Neuprez, A. et al. Aesthetic discomfort in hand osteoarthritis: results from the LIège Hand Osteoarthritis Cohort (LIHOC). Arthritis Res. Ther. 17, 346 (2015).

    PubMed  PubMed Central  Google Scholar 

  64. Liu, R., Damman, W., Kaptein, A. A., Rosendaal, F. R. & Kloppenburg, M. Coping styles and disability in patients with hand osteoarthritis. Rheumatology (Oxford). 55, 411–418 (2016).

    PubMed  Google Scholar 

  65. Gilpin, H. R., Moseley, G. L., Stanton, T. R. & Newport, R. Evidence for distorted mental representation of the hand in osteoarthritis. Rheumatology (Oxford). 54, 678–682 (2015).

    PubMed  Google Scholar 

  66. Oppong, R. et al. Joint protection and hand exercises for hand osteoarthritis: an economic evaluation comparing methods for the analysis of factorial trials. Rheumatology (Oxford). 54, 876–883 (2015).

    PubMed  Google Scholar 

  67. Becker, S. J. et al. Medical services and associated costs vary widely among surgeons treating patients with hand osteoarthritis. Clin. Orthop. Relat. Res. 473, 1111–1117 (2015).

    PubMed  Google Scholar 

  68. Marks, M. et al. Healthcare costs and loss of productivity in patients with trapeziometacarpal osteoarthritis. J. Hand. Surg. Eur. 40, 927–934 (2015).

    CAS  Google Scholar 

  69. Wolf, J. M., Atroshi, I., Zhou, C., Karlsson, J. & Englund, M. Sick leave after surgery for thumb carpometacarpal osteoarthritis: a population-based study. J. Hand Surg. Am. 43, 439–447 (2018).

    Google Scholar 

  70. Kloppenburg, M. et al. OARSI clinical trials recommendations: design and conduct of clinical trials for hand osteoarthritis. Osteoarthr. Cartil. 23, 772–786 (2015).

    CAS  PubMed  Google Scholar 

  71. Hunter, D. J. et al. OARSI clinical trials recommendations: hand imaging in clinical trials in osteoarthritis. Osteoarthr. Cartil. 23, 732–746 (2015).

    CAS  PubMed  Google Scholar 

  72. Sakellariou, G. et al. EULAR recommendations for the use of imaging in the clinical management of peripheral joint osteoarthritis. Ann. Rheum. Dis. 76, 1484–1494 (2017).

    PubMed  Google Scholar 

  73. Matsos, M. et al. Ultrasound of the hands and feet for rheumatological disorders: influence on clinical diagnostic confidence and patient management. Skeletal Radiol. 38, 1049–1054 (2009).

    PubMed  Google Scholar 

  74. Maheu, E. et al. Reproducibility and sensitivity to change of four scoring methods for the radiological assessment of osteoarthritis of the hand. Ann. Rheum. Dis. 66, 464–469 (2007).

    PubMed  Google Scholar 

  75. Bijsterbosch, J. et al. Reliability, sensitivity to change and feasibility of three radiographic scoring methods for hand osteoarthritis. Ann. Rheum. Dis. 70, 1465–1467 (2011).

    CAS  PubMed  Google Scholar 

  76. Haugen, I. K., Slatkowsky-Christensen, B., Faraj, K., van der Heijde, D. & Kvien, T. K. The comparison of magnetic resonance imaging and radiographs to assess structural progression over 5 years in hand osteoarthritis. Rheumatology (Oxford). 56, 371–377 (2017).

    PubMed  Google Scholar 

  77. Keen, H. I. et al. Can ultrasonography improve on radiographic assessment in osteoarthritis of the hands? A comparison between radiographic and ultrasonographic detected pathology. Ann. Rheum. Dis. 67, 1116–1120 (2008).

    CAS  PubMed  Google Scholar 

  78. Abraham, A. M., Pearce, M. S., Mann, K. D., Francis, R. M. & Birrell, F. Population prevalence of ultrasound features of osteoarthritis in the hand, knee and hip at age 63 years: the Newcastle thousand families birth cohort. BMC Musculoskelet. Disord. 15, 162 (2014).

    PubMed  PubMed Central  Google Scholar 

  79. Usón, J. et al. Symptomatic and asymptomatic interphalageal osteoarthritis: an ultrasonographic study. Reumatol Clin. 10, 278–282 (2014).

    PubMed  Google Scholar 

  80. Mathiessen, A. et al. Ultrasonographic assessment of osteophytes in 127 patients with hand osteoarthritis: exploring reliability and associations with MRI, radiographs and clinical joint findings. Ann. Rheum. Dis. 72, 51–56 (2013).

    PubMed  Google Scholar 

  81. Haugen, I. K. et al. Comparison of features by MRI and radiographs of the interphalangeal finger joints in patients with hand osteoarthritis. Ann. Rheum. Dis. 71, 345–350 (2012).

    PubMed  Google Scholar 

  82. Keen, H. I. et al. An ultrasonographic study of osteoarthritis of the hand: synovitis and its relationship to structural pathology and symptoms. Arthritis Rheum. 59, 1756–1763 (2008).

    PubMed  Google Scholar 

  83. Kortekaas, M. C. et al. Pain in hand osteoarthritis is associated with inflammation: the value of ultrasound. Ann. Rheum. Dis. 69, 1367–1369 (2010).

    PubMed  Google Scholar 

  84. Liu, R. et al. Bone marrow lesions on magnetic resonance imaging in hand osteoarthritis are associated with pain and interact with synovitis. Osteoarthr. Cartil. 25, 1093–1099 (2017).

    CAS  PubMed  Google Scholar 

  85. Keen, H. I. et al. The development of a preliminary ultrasonographic scoring system for features of hand osteoarthritis. Ann. Rheum. Dis. 67, 651–655 (2008).

    CAS  PubMed  Google Scholar 

  86. Iagnocco, A. et al. The reliability of musculoskeletal ultrasound in the detection of cartilage abnormalities at the metacarpo-phalangeal joints. Osteoarthr. Cartil. 20, 1142–1146 (2012).

    CAS  PubMed  Google Scholar 

  87. Wittoek, R. et al. Reliability and construct validity of ultrasonography of soft tissue and destructive changes in erosive osteoarthritis of the interphalangeal finger joints: a comparison with MRI. Ann. Rheum. Dis. 70, 278–283 (2011).

    PubMed  Google Scholar 

  88. Kortekaas, M. C., Kwok, W. Y., Reijnierse, M., Huizinga, T. W. & Kloppenburg, M. Osteophytes and joint space narrowing are independently associated with pain in finger joints in hand osteoarthritis. Ann. Rheum. Dis. 70, 1835–1837 (2011).

    PubMed  Google Scholar 

  89. Spolidoro Paschoal, N. O. et al. Interphalangeal joint sonography of symptomatic hand osteoarthritis: clinical and functional correlation. J. Ultrasound Med. 36, 311–319 (2017).

    PubMed  Google Scholar 

  90. Guermazi, A., Roemer, F. W. & Hayashi, D. Imaging of osteoarthritis: update from a radiological perspective. Curr. Opin. Rheumatol. 23, 484–491 (2011).

    PubMed  Google Scholar 

  91. Haugen, I. K. et al. Hand osteoarthritis and MRI: development and first validation step of the proposed Oslo hand osteoarthritis MRI score. Ann. Rheum. Dis. 70, 1033–1038 (2011).

    PubMed  Google Scholar 

  92. Haugen, I. K. et al. Associations between MRI-defined synovitis, bone marrow lesions and structural features and measures of pain and physical function in hand osteoarthritis. Ann. Rheum. Dis. 71, 899–904 (2012).

    PubMed  Google Scholar 

  93. Kortekaas, M. C. et al. Magnetic resonance imaging in hand osteoarthritis: intraobserver reliability and criterion validity for clinical and structural characteristics. J. Rheumatol. 42, 1224–1230 (2015).

    CAS  PubMed  Google Scholar 

  94. Ramonda, R. et al. A recently developed MRI scoring system for hand osteoarthritis: its application in a clinical setting. Clin. Rheumatol. 35, 2079–2086 (2016).

    PubMed  Google Scholar 

  95. Haugen, I. K. et al. Iterative development and reliability of the OMERACT Hand Osteoarthritis MRI Scoring System. J. Rheumatol. 41, 386–391 (2014).

    PubMed  Google Scholar 

  96. Haugen, I. K. et al. The longitudinal reliability and responsiveness of the OMERACT Hand Osteoarthritis Magnetic Resonance Imaging Scoring System (HOAMRIS). J. Rheumatol. 42, 2486–2491 (2015).

    PubMed  Google Scholar 

  97. Haugen, I. K. et al. Increasing synovitis and bone marrow lesions are associated with incident joint tenderness in hand osteoarthritis. Ann. Rheum. Dis. 75, 702–708 (2016).

    CAS  PubMed  Google Scholar 

  98. Damman, W. et al. Bone marrow lesions and synovitis on MRI associate with radiographic progression after 2 years in hand osteoarthritis. Ann. Rheum. Dis. 76, 214–217 (2017).

    CAS  PubMed  Google Scholar 

  99. Haugen, I. K. et al. MRI findings predict radiographic progression and development of erosions in hand osteoarthritis. Ann. Rheum. Dis. 75, 117–123 (2016).

    PubMed  Google Scholar 

  100. Kortekaas, M. C., Kwok, W. Y., Reijnierse, M. & Kloppenburg, M. Inflammatory ultrasound features show independent associations with progression of structural damage after over 2 years of follow-up in patients with hand osteoarthritis. Ann. Rheum. Dis. 74, 1720–1724 (2015).

    PubMed  Google Scholar 

  101. Mathiessen, A., Slatkowsky-Christensen, B., Kvien, T. K., Hammer, H. B. & Haugen, I. K. Ultrasound-detected inflammation predicts radiographic progression in hand osteoarthritis after 5 years. Ann. Rheum. Dis. 75, 825–830 (2016).

    PubMed  Google Scholar 

  102. Keen, H. I., Wakefield, R. J., Hensor, E. M., Emery, P. & Conaghan, P. G. Response of symptoms and synovitis to intra-muscular methylprednisolone in osteoarthritis of the hand: an ultrasonographic study. Rheumatology (Oxford). 49, 1093–1100 (2010).

    PubMed  Google Scholar 

  103. Klauser, A. S. et al. Sonographic criteria for therapy follow-up in the course of ultrasound-guided intra-articular injections of hyaluronic acid in hand osteoarthritis. Eur. J. Radiol. 81, 1607–1611 (2012).

    PubMed  Google Scholar 

  104. Kortekaas, M. C. et al. Follow-up study of inflammatory ultrasound features in hand osteoarthritis over a period of 3 months: variable as well as constant. Osteoarthr. Cartil. 22, 40–43 (2014).

    CAS  PubMed  Google Scholar 

  105. Finzel, S. et al. Inflammatory bone spur formation in psoriatic arthritis is different from bone spur formation in hand osteoarthritis. Arthritis Rheumatol. 66, 2968–2975 (2014).

    PubMed  Google Scholar 

  106. Halilaj, E. et al. The morphology of the thumb carpometacarpal joint does not differ between men and women, but changes with aging and early osteoarthritis. J. Biomech. 47, 2709–2714 (2014).

    PubMed  PubMed Central  Google Scholar 

  107. Lee, A. T. et al. Trapezium trabecular morphology in carpometacarpal arthritis. J. Hand. Surg. Am. 38, 309–315 (2013).

    PubMed  Google Scholar 

  108. National Institutes of Health. Optical Imaging. NIH https://report.nih.gov/NIHfactsheets/ViewFactSheet.aspx?csid=105 (2013).

  109. Gompels, L. L., Lim, N. H., Vincent, T. & Paleolog, E. M. In vivo optical imaging in arthritis—an enlightening future? Rheumatology (Oxford). 49, 1436–1446 (2010).

    PubMed  Google Scholar 

  110. Haugen, I. K., Slatkowsky-Christensen, B., Bøyesen, P., van der Heijde, D. & Kvien, T. K. Cross-sectional and longitudinal associations between radiographic features and measures of pain and physical function in hand osteoarthritis. Osteoarthr. Cartil. 21, 1191–1198 (2013).

    CAS  PubMed  Google Scholar 

  111. Barr, A. J. et al. A systematic review of the relationship between subchondral bone features, pain and structural pathology in peripheral joint osteoarthritis. Arthritis Res. Ther. 17, 228 (2015).

    PubMed  PubMed Central  Google Scholar 

  112. Magnusson, K. et al. Diabetes is associated with increased hand pain in erosive hand osteoarthritis: data from a population-based study. Arthritis Care Res. (Hoboken). 67, 187–195 (2015).

    PubMed  Google Scholar 

  113. Lee, H. J., Paik, N. J., Lim, J. Y., Kim, K. W. & Gong, H. S. The impact of digit-related radiographic osteoarthritis of the hand on grip-strength and upper extremity disability. Clin. Orthop. Relat. Res. 470, 2202–2208 (2012).

    PubMed  PubMed Central  Google Scholar 

  114. Mancarella, L. et al. Ultrasound detected inflammation is associated with the development of new bone erosions in hand osteoarthritis: a longitudinal study over 3.9 years. Osteoarthr. Cartil. 23, 1925–1932 (2015).

    CAS  PubMed  Google Scholar 

  115. Mancarella, L., Addimanda, O., Cavallari, C. & Meliconi, R. Synovial inflammation drives structural damage in hand osteoarthritis: a narrative literature review. Curr. Rheumatol. Rev. 13, 43–50 (2017).

    PubMed  Google Scholar 

  116. Damman, W. et al. Do comorbidities play a role in hand osteoarthritis disease burden? Data from hand osteoarthritis secondary care cohort. J. Rheumatol. 44, 1659–1666 (2017).

    PubMed  Google Scholar 

  117. Brandt, K. D., Dieppe, P. & Radin, E. L. Commentary: is it useful to subset ‘primary’ osteoarthritis? A critique based evidence regarding the etiopathogenesis of osteoarthritis. Semin. Arthritis Rheum. 39, 81–95 (2009).

    PubMed  Google Scholar 

  118. Droz-Bartholet, F., Verhoeven, F., Prati, C. & Wendling, D. Prevention of hand osteoarthritis by hemiparesis. Arthritis Rheumatol. 68, 647 (2016).

    PubMed  Google Scholar 

  119. Tan, A. L. et al. Combined high-resolution magnetic resonance imaging and histological examination to explore the role of ligaments and tendons in the phenotypic expression of early hand osteoarthritis. Ann. Rheum. Dis. 65, 1267–1272 (2006).

    CAS  PubMed  PubMed Central  Google Scholar 

  120. Ishimori, M. L. et al. Heritability patterns in hand osteoarthritis: the role of osteophytes. Arthritis Res. Ther. 12, R180 (2010).

    PubMed  PubMed Central  Google Scholar 

  121. Ryder, J. J. et al. Genetic associations in peripheral joint osteoarthritis and spinal degenerative disease: a systematic review. Ann. Rheum. Dis. 67, 584–591 (2008).

    CAS  PubMed  Google Scholar 

  122. Stefánsson, S. E. et al. Genomewide scan for hand osteoarthritis: a novel mutation in matrilin-3. Am. J. Hum. Genet. 72, 1448–1459 (2003).

    PubMed  PubMed Central  Google Scholar 

  123. Zhai, G. et al. A genome-wide association study suggests that a locus within the ataxin 2 binding protein 1 gene is associated with hand osteoarthritis: the Treat-OA consortium. J. Med. Genet. 46, 614–616 (2009).

    CAS  PubMed  PubMed Central  Google Scholar 

  124. Kerkhof, H. J. M. et al. A genome-wide association study identifies an osteoarthritis susceptibility locus on chromosome 7q22. Arthritis Rheum. 62, 499–510 (2010).

    CAS  PubMed  PubMed Central  Google Scholar 

  125. Hollander, den, W. et al. Genome-wide association and functional studies identify a role for matrix Gla protein in osteoarthritis of the hand. Ann. Rheum. Dis. 76, 2046–2053 (2017).

    CAS  Google Scholar 

  126. Styrkarsdottir, U. et al. Severe osteoarthritis of the hand associates with common variants within the ALDH1A2 gene and with rare variants at 1p31. Nat. Genet. 46, 498–502 (2014).

    CAS  PubMed  Google Scholar 

  127. Hämäläinen, S. et al. Genetic influences on hand osteoarthritis in Finnish women—a replication study of candidate genes. PLOS ONE 9, e97417 (2014).

    PubMed  PubMed Central  Google Scholar 

  128. Zhang, R. et al. A comprehensive meta-analysis of association between genetic variants of GDF5 and osteoarthritis of the knee, hip and hand. Inflamm. Res. 64, 405–414 (2015).

    CAS  PubMed  Google Scholar 

  129. Zhang, F. et al. Association between KLOTHO gene and hand osteoarthritis in a female Caucasian population. YJOCA 15, 624–629 (2007).

    CAS  Google Scholar 

  130. Meulenbelt, I. et al. A genetic association study of the IGF-1 gene and radiological osteoarthritis in a population-based cohort study (the Rotterdam study). Ann. Rheum. Dis. 57, 371–374 (1998).

    CAS  PubMed  PubMed Central  Google Scholar 

  131. Bijsterbosch, J. et al. Association study of candidate genes for the progression of hand osteoarthritis. Osteoarthr. Cartil. 21, 565–569 (2013).

    CAS  PubMed  Google Scholar 

  132. Taipale, M., Solovieva, S., Leino-Arjas, P. & Männikkö, M. Functional polymorphisms in asporin and CILP together with joint loading predispose to hand osteoarthritis. BMC Genet. 18, 108 (2017).

    PubMed  PubMed Central  Google Scholar 

  133. Misra, D. et al. Matrix Gla protein polymorphism, but not concentrations, is associated with radiographic hand osteoarthritis. J. Rheumatol 38, 1960–1965 (2011).

    CAS  PubMed  PubMed Central  Google Scholar 

  134. Suk, E.-K. et al. Association of ENPP1 gene polymorphisms with hand osteoarthritis in a Chuvasha population. Arthritis Res. Ther. 7, R1082–R1090 (2005).

    CAS  PubMed  PubMed Central  Google Scholar 

  135. Kämäräinen, O.-P. et al. Aggrecan core protein of a certain length is protective against hand osteoarthritis. YJOCA 14, 1075–1080 (2006).

    Google Scholar 

  136. Hämäläinen, S., Solovieva, S., Vehmas, T., Leino-Arjas, P. & Hirvonen, A. Variations in the TNFα gene and their interactions with the IL4R and IL10 genes in relation to hand osteoarthritis. BMC Musculoskelet Disord. 15, 311 (2014).

    PubMed  PubMed Central  Google Scholar 

  137. Vargiolu, M. et al. Interleukin-4/interleukin-4 receptor gene polymorphisms in hand osteoarthritis. Osteoarthr. Cartil. 18, 810–816 (2010).

    CAS  PubMed  Google Scholar 

  138. Blumenfeld, O. et al. Association of interleukin-6 gene polymorphisms with hand osteoarthritis and hand osteoporosis. Cytokine 69, 94–101 (2014).

    CAS  PubMed  Google Scholar 

  139. Näkki, A. et al. Allelic variants of IL1R1 gene associate with severe hand osteoarthritis. BMC Med. Genet. 11, 50 (2010).

    PubMed  PubMed Central  Google Scholar 

  140. Moxley, G., Han, J., Stern, A. G. & Riley, B. P. Potential influence of IL1B haplotype and IL1A-IL1B-IL1RN extended haplotype on hand osteoarthritis risk. YJOCA 15, 1106–1112 (2007).

    CAS  Google Scholar 

  141. Zhu, L. et al. Polymorphic variants in ALDH1A2 determine the expression level of ALDH1A2 and CYP19A1 in the cartilage of patients undergoing trapeziectomy for severe thumb osteoarthritis. Osteoarthr. Cartil. 26, (Suppl. 1) S157 (2018).

    Google Scholar 

  142. Ho, L. J. et al. Retinoic acid blocks pro-inflammatory cytokine-induced matrix metalloproteinase production by down-regulating JNK-AP-1 signaling in human chondrocytes. Biochem. Pharmacol. 70, 200–208 (2005).

    CAS  PubMed  Google Scholar 

  143. Stanton, H. et al. Investigating ADAMTS-mediated aggrecanolysis in mouse cartilage. Nat. Protoc. 6, 388–404 (2011).

    CAS  PubMed  Google Scholar 

  144. Watt, F. E. Hand osteoarthritis, menopause and menopausal hormone therapy. Maturitas 83, 13–18 (2016).

    PubMed  Google Scholar 

  145. Petrosino, J. M., Disilvestro, D. & Ziouzenkova, O. Aldehyde dehydrogenase 1A1: friend or foe to female metabolism? Nutrients 6, 950–973 (2014).

    PubMed  PubMed Central  Google Scholar 

  146. Hussain, S. et al. Ultrasonography-detected subclinical inflammation in patients with hand osteoarthritis and established rheumatoid arthritis: a comparison between two different pathologies using the same ultrasound examination protocol. Musculoskeletal Care 16, 26–31 (2018).

    PubMed  Google Scholar 

  147. Kortekaas, M. C., Kwok, W. Y., Reijnierse, M., Stijnen, T. & Kloppenburg, M. Association of inflammation with development of erosions in patients with hand osteoarthritis: a prospective ultrasonography study. Arthritis Rheumatol. 68, 392–397 (2016).

    PubMed  Google Scholar 

  148. Lennerová, T., Pavelka, K. & Šenolt, L. Biomarkers of hand osteoarthritis. Rheumatol. Int. 38, 725–735 (2018).

    PubMed  Google Scholar 

  149. Fioravanti, A. et al. Can adipokines serum levels be used as biomarkers of hand osteoarthritis? Biomarkers 23, 265–270 (2018).

    CAS  PubMed  Google Scholar 

  150. Roux, C. H. et al. MRI and serum biomarkers correlate with radiographic features in painful hand osteoarthritis. Clin. Exp. Rheumatol. 34, 991–998 (2016).

    PubMed  Google Scholar 

  151. Spolidoro Paschoal, N. O., Natour, J., Machado, F. S., de Oliveira, H. A. & Furtado, R. N. Effectiveness of triamcinolone hexacetonide intraarticular injection in interphalangeal joints: a 12-week randomized controlled trial in patients with hand osteoarthritis. J. Rheumatol. 42, 1869–1877 (2015).

    Google Scholar 

  152. Lee, W. et al. Efficacy of hydroxychloroquine in hand osteoarthritis: a randomized, double blind, placebo-controlled trial. Arthritis Care Res. (Hoboken) 70, 1320–1325 (2017).

    Google Scholar 

  153. Kingsbury, S. R. et al. Hydroxychloroquine effectiveness in reducing symptoms of hand osteoarthritis: a randomized trial. Ann. Intern. Med. 168, 385–389 (2018).

    PubMed  Google Scholar 

  154. Chevalier, X. et al. Adalimumab in patients with hand osteoarthritis refractory to analgesics and NSAIDs: a randomised, multicentre, double-blind, placebo-controlled trial. Ann. Rheum. Dis. 74, 1697–1705 (2015).

    CAS  PubMed  Google Scholar 

  155. Aitken, D. et al. A randomised double-blind placebo-controlled crossover trial of HUMira (adalimumab) for erosive hand OsteoaRthritis- the HUMOR trial. Osteoarthr. Cartil. 26, 880–887 (2018).

    CAS  PubMed  Google Scholar 

  156. Kloppenburg, M. et al. A phase 2a, placebo-controlled, randomized study of ABT-981, an anti-interleukin-1α and -1β dual variable domain immunoglobulin, to treat erosive hand osteoarthritis (EHOA) [abstract OP0168]. Ann. Rheum. Dis. 76, (Suppl. 2) 122 (2017).

    Google Scholar 

  157. Lue, S., Koppikar, S., Shaikh, K., Mahendira, D. & Towheed, T. E. Systematic review of non-surgical therapies for osteoarthritis of the hand: an update. Osteoarthr. Cartil. 25, 1379–1389 (2017).

    CAS  PubMed  Google Scholar 

  158. Mahendira, D. & Towheed, T. E. Systematic review of non-surgical therapies for osteoarthritis of the hand: an update. Osteoarthr. Cartil. 17, 1263–1268 (2009).

    CAS  PubMed  Google Scholar 

  159. Dziedzic, K. S. et al. Implementing core NICE guidelines for osteoarthritis in primary care with a model consultation (MOSAICS): a cluster randomised controlled trial. Osteoarthr. Cartil. 26, 43–53 (2018).

    CAS  PubMed  PubMed Central  Google Scholar 

  160. Moe, R. H. Effectiveness of an integrated multidisciplinary osteoarthritis outpatient program versus outpatient clinic as usual: a randomized controlled trial. J. Rheumatol. 43, 411–418 (2016).

    CAS  PubMed  Google Scholar 

  161. Arthritis Research UK. A guidebook for people who have osteoarthritis. Keele University www.arthritisresearchuk.org/arthritis-information/keele-oa-guide.aspx (2014).

  162. Jordan, K. P. et al. Effect of a model consultation informed by guidelines on recorded quality of care of osteoarthritis (MOSAICS): a cluster randomised controlled trial in primary care. Osteoarthr. Cartil. 25, 1588–1597 (2017).

    CAS  PubMed  PubMed Central  Google Scholar 

  163. Arthritis Research UK. Osteoarthritis of the hand. Keele University www.keele.ac.uk/media/keeleuniversity/ri/primarycare/OA%20Hand%20Leaflet%20v.0.10%2002.02.18%20LC%20(1).pdf (2017).

  164. Dziedzic, K. et al. Self-management approaches for osteoarthritis in the hand: a 2 × 2 factorial randomised trial. Ann. Rheum. Dis. 74, 108–118 (2015).

    PubMed  Google Scholar 

  165. Kjeken, I., Grotle, M., Hagen, K. B. & Østerås, N. Development of an evidence-based exercise programme for people with hand osteoarthritis. Scand. J. Occup. Ther. 22, 103–116 (2015).

    PubMed  Google Scholar 

  166. Hennig, T. et al. Effect of home-based hand exercises in women with hand osteoarthritis: a randomised controlled trial. Ann. Rheum. Dis. 74, 1501–1508 (2015).

    PubMed  Google Scholar 

  167. Østerås, N. et al. Limited effects of exercises in people with hand osteoarthritis: results from a randomized controlled trial. Osteoarthr. Cartil. 22, 1224–1233 (2014).

    PubMed  Google Scholar 

  168. Østerås, N. Exercise for hand osteoarthritis. Cochrane Database Syst. Rev. 31, CD010388 (2017).

    Google Scholar 

  169. Uthman, O. A. et al. Exercise for lower limb osteoarthritis: systematic review incorporating trial sequential analysis and network meta-analysis. BMJ 347, f5555 (2013).

    PubMed  PubMed Central  Google Scholar 

  170. Magnusson, K. et al. Body mass index and progressive hand osteoarthritis: data from the Oslo hand osteoarthritis cohort. Scand. J. Rheumatol. 44, 331–336 (2015).

    CAS  PubMed  Google Scholar 

  171. Jiang, L. Body mass index and hand osteoarthritis susceptibility: an updated meta-analysis. Int. J. Rheum. Dis. 19, 1244–1254 (2016).

    PubMed  Google Scholar 

  172. Spaans, A. J. Conservative treatment of thumb base osteoarthritis: a systematic review. J. Hand Surg. Am. 40, 16–21 (2015).

    PubMed  Google Scholar 

  173. Bertozzi, L. Investigation of the effect of conservative interventions in thumb carpometacarpal osteoarthritis: systematic review and meta-analysis. Disabil Rehabil. 37, 2025–2043 (2015).

    PubMed  Google Scholar 

  174. Gooberman-Hill, R. et al. Designing a placebo device: involving service users in clinical trial design. Health Expect. 16, 100–110 (2013).

    Google Scholar 

  175. Arthritis Research UK. Osteoarthritis of the thumb therapy (OTTER) trial. University of Southampton https://www.southampton.ac.uk/healthsciences/research/projects/osteoarthritis_of_the_thumb_therapy.page (2018).

  176. National Institute for Health Research. Osteoarthritis thumb therapy trial II. NIHR https://ukctg.nihr.ac.uk/trials/trial-details/trial-details?trialNumber=ISRCTN54744256 (2018).

  177. Bani, M. A. et al. A custom-made neoprene thumb carpometacarpal orthosis with thermoplastic stabilization: an orthosis that promotes function and improvement in patients with the first carpometacarpal joint osteoarthritis. Prosthet. Orthot. Int. 38, 79–82 (2014).

    PubMed  Google Scholar 

  178. Hamann, N. et al. Stabilization effectiveness and functionality of different thumb orthoses in female patients with first carpometacarpal joint osteoarthritis. Clin. Biomech. 29, 1170–1176 (2014).

    Google Scholar 

  179. Grenier, M. L., Mendonca, R. & Dalley, P. The effectiveness of orthoses in the conservative management of thumb CMC joint osteoarthritis: an analysis of functional pinch strength. J. Hand Ther. 29, 307–313 (2016).

    PubMed  Google Scholar 

  180. Valdes, K., Naughton, N. & Algar, L. Linking ICF components to outcome measures for orthotic intervention for CMC OA: a systematic review. J. Hand Ther. 29, 396–404 (2016).

    CAS  PubMed  Google Scholar 

  181. Vegt, A. E. et al. The effect of two different orthoses on pain, hand function, patient satisfaction and preference in patients with thumb carpometacarpal osteoarthritis: a multicentre, crossover, randomised controlled trial. Bone Joint J. 99-B, 237–244 (2017).

    PubMed  Google Scholar 

  182. Watt, F. E. et al. Night-time immobilization of the distal interphalangeal joint reduces pain and extension deformity in hand osteoarthritis. Rheumatology (Oxford). 53, 1142–1149 (2014).

    PubMed  PubMed Central  Google Scholar 

  183. Hammond, A., Jones, V. & Prior, Y. The effects of compression gloves on hand symptoms and hand function in rheumatoid arthritis and hand osteoarthritis: a systematic review. Clin. Rehabil. 30, 213–224 (2016).

    PubMed  Google Scholar 

  184. Fortunati, N. A., Fioravanti, A., Seri, G., Cinelli, S. & Tenti, S. May spa therapy be a valid opportunity to treat hand osteoarthritis? A review of clinical trials and mechanisms of action. Int. J. Biometeorol. 60, 1–8 (2016).

    PubMed  Google Scholar 

  185. Villafañe, J. H. & Herrero, P. Conservative treatment of myofascial trigger points and joint mobilization for management in patients with thumb carpometacarpal osteoarthritis. J. Hand Ther. 29, 89–92 (2016).

    PubMed  Google Scholar 

  186. Wade, R. G., Paxman, C. B., Tucker, N. C. & Southern, S. Kinesiology taping reduces the pain of finger osteoarthritis: a pilot single-blinded two-group parallel randomized trial. J. Pain. Res. 11, 1281–1288 (2018).

    PubMed  PubMed Central  Google Scholar 

  187. Paolillo, A. R., Paolillo, F. R., João, J. P., João, H. A. & Bagnato, V. S. Synergic effects of ultrasound and laser on the pain relief in women with hand osteoarthritis. Lasers Med. Sci. 30, 279–286 (2015).

    PubMed  Google Scholar 

  188. Kloppenburg, M. et al. 2018 update of the EULAR recommendations for the management of hand osteoarthritis. Ann. Rheum. Dis. https://doi.org/10.1136/annrheumdis-2018-213826 (2018).

    Article  Google Scholar 

  189. Kroon, F., Kloppenburg, M., Schoones, J. & Carmona, L. Systematic literature review (SLR) for the 2018 update of the EULAR management recommendations for hand osteoarthritis (OA). Ann. Rheum. Dis. 77, 1133 (2018).

    Google Scholar 

  190. Zou, K. et al. Examination of overall treatment effect and the proportion attributable to contextual effect in osteoarthritis: meta-analysis of randomised controlled trials. Ann. Rheum. Dis. 75, 1964–1970 (2016).

    PubMed  PubMed Central  Google Scholar 

  191. Zeng, C. et al. Relative efficacy and safety of topical non-steroidal anti-inflammatory drugs for osteoarthritis: a systematic review and network meta-analysis of randomised controlled trials and observational studies. Br. J. Sports. Med. 52, 642–650 (2018).

    PubMed  PubMed Central  Google Scholar 

  192. Rannou, F., Pelletier, J. P. & Martel-Pelletier, J. Efficacy and safety of topical NSAIDs in the management of osteoarthritis: evidence from real-life setting trials and surveys. Semin. Arthritis Rheum. 45, S18–S21 (2016).

    CAS  PubMed  Google Scholar 

  193. Laslett, L. L. & Jones, G. Capsaicin for osteoarthritis pain. Prog. Drug Res. 68, 277–291 (2014).

    CAS  PubMed  Google Scholar 

  194. Monfort, J. et al. Comparative efficacy of intra-articular hyaluronic acid and corticoid injections in osteoarthritis of the first carpometacarpal joint: results of a 6-month single-masked randomized study. Joint Bone Spine. 82, 116–121 (2015).

    CAS  PubMed  Google Scholar 

  195. Jahangiri, A., Moghaddam, F. R. & Najafi, S. Hypertonic dextrose versus corticosteroid local injection for the treatment of osteoarthritis in the first carpometacarpal joint: a double-blind randomized clinical trial. J. Orthop. Sci. 19, 737–743 (2014).

    PubMed  Google Scholar 

  196. McCann, P. A., Wakeley, C. J. & Amirfeyz, R. The effect of ultrasound guided steroid injection on progression to surgery in thumb CMC arthritis. Hand Surg. 19, 49–52 (2014).

    CAS  PubMed  Google Scholar 

  197. Trellu, S., Dadoun, S., Berenbaum, F., Fautrel, B. & Gossec, L. Intra-articular injections in thumb osteoarthritis: a systematic review and meta-analysis of randomized controlled trials. Joint Bone Spine. 82, 315–319 (2015).

    PubMed  Google Scholar 

  198. Kroon, F. P., Rubio, R., Schoones, J. W. & Kloppenburg, M. Intra-articular therapies in the treatment of hand osteoarthritis: a systematic literature review. Drugs Aging. 33, 119–133 (2016).

    CAS  PubMed  Google Scholar 

  199. National Institute for Health & Care Excellence. Non-steroidal anti-inflammatory drugs. NICE https://www.nice.org.uk/advice/ktt13/resources/nonsteroidal-antiinflammatory-drugs-58757951055301 (2015).

  200. Sanders, D. et al. Pharmacologic modulation of hand pain in osteoarthritis: a double-blind placebo-controlled functional magnetic resonance imaging study using naproxen. Arthritis Rheumatol. 67, 741–751 (2015).

    CAS  PubMed  PubMed Central  Google Scholar 

  201. Ma, J., Talukdar, R. & Gainers-Hasugluw, V. Pilot open observations on doxycycline treatment for erosive osteoarthritis of the hand. J. Clin. Rheumatol. 21, 38–39 (2015).

    PubMed  Google Scholar 

  202. Park, J. K. et al. Efficacy and tolerability of GCSB-5 for hand osteoarthritis: a randomized, controlled trial. Clin. Ther. 38, 1858–1868 (2016).

    CAS  PubMed  Google Scholar 

  203. Watt, F. E. & Gulati, M. New drug treatments for osteoarthritis: what is on the horizon? EMJ 2, 50–58 (2017).

    Google Scholar 

  204. Grevan, D. E. et al. Preclinical characterisation of the GM-CSF receptor as a therapeutic target in rheumatoid arthritis. Ann. Rheum. Dis. 74, 1924–1930 (2015).

    Google Scholar 

  205. US National Library of Medicine. ClinicalTrials.gov https://clinicaltrials.gov/ct2/show/NCT02477059 (2018).

  206. Singh, J. A., Noorbaloochi, S., MacDonald, R. & Maxwell, L. J. Chondroitin for osteoarthritis. Cochrane Database Syst. Rev. 28, CD005614 (2015).

    Google Scholar 

  207. Frouzakis, R., Herren, D. B. & Marks, M. Evaluation of expectations and expectation fulfillment in patients treated for trapeziometacarpal osteoarthritis. J. Hand Surg. Am. 40, 483–490 (2015).

    PubMed  Google Scholar 

  208. Hochberg, M. C. et al. American College of Rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee. Arthritis Care Res. (Hoboken). 64, 465–474 (2012).

    CAS  PubMed  Google Scholar 

  209. Manara, M. et al. Italian Society for Rheumatology recommendations for the management of hand osteoarthritis. Reumatismo 65, 167–185 (2013).

    CAS  PubMed  Google Scholar 

  210. Kloppenburg, M. et al. Report from the OMERACT Hand Osteoarthritis Working Group: set of core domains and preliminary set of instruments for use in clinical trials and observational studies. J. Rheumatol. 42, 2190–2197 (2015).

    CAS  PubMed  Google Scholar 

  211. Riyazi, N. et al. Evidence for familial aggregation of hand, hip, and spine but not knee osteoarthritis in siblings with multiple joint involvement: the GARP study. Ann. Rheum. Dis. 64, 438–443 (2005).

    CAS  PubMed  Google Scholar 

  212. Andrianakos, A. A. et al. Prevalence of symptomatic knee, hand, and hip osteoarthritis in Greece. The ESORDIG study. J. Rheumatol. 33, 2507–2513 (2006).

    PubMed  Google Scholar 

  213. Castell, M. V. et al. Osteoarthritis and frailty in elderly individuals across six European countries: results from the European Project on OSteoArthritis (EPOSA). BMC Musculoskelet. Disord. 15, 359 (2015).

    Google Scholar 

  214. Kellgren, J. H. & Lawrence, J. S. Radiological assessment of osteo-arthrosis. Ann. Rheum. Dis. 16, 494–502 (1957).

    CAS  PubMed  PubMed Central  Google Scholar 

  215. Kellgren, J. H., Jeffrey, M. R. & Ball, J. The Epidemiology of Chronic Rheumatism: Atlas of Standard Radiographs of Arthritis Vol. 2 (Blackwell Scientific Publications, Oxford, UK, 1963).

    Google Scholar 

  216. Sowers, M. et al. Progression of osteoarthritis of the hand and metacarpal bone loss. A twenty-year followup of incident cases. Arthritis. Rheum. 34, 36–42 (1991).

    CAS  PubMed  Google Scholar 

  217. Hochberg, M. et al. Bone mineral density and osteoarthritis: data from the Baltimore Longitudinal Study of Aging. Osteoarthr. Cartil. 12, 45–48 (2004).

    Google Scholar 

  218. Wilder, F. V., Barrett, J. P. & Farina, E. J. Joint-specific prevalence of osteoarthritis of the hand. Osteoarthr. Cartil. 14, 953–957 (2006).

    CAS  PubMed  Google Scholar 

  219. Toba, N. et al. Prevalence and involvement patterns of radiographic hand osteoarthritis in Japanese women: the Hizen-Oshima study. J. Bone Miner. Metab. 24, 344–348 (2006).

    PubMed  Google Scholar 

  220. Kalichman, L. & Hernández-Molina, G. Hand osteoarthritis: an epidemiological perspective. Semin. Arthritis. Rheum. 39, 465–476 (2010).

    PubMed  Google Scholar 

  221. Chaisson, C. E. et al. Radiographic hand osteoarthritis: incidence, patterns, and influence of pre-existing disease in a population based sample. J. Rheumatol. 24, 1337–1343 (1997).

    CAS  PubMed  Google Scholar 

  222. Güler-Yüksel, M. et al. Accelerated metacarpal bone mineral density loss is associated with radiographic progressive hand osteoarthritis. Ann. Rheum. Dis. 70, 1625–1630 (2011).

    PubMed  Google Scholar 

  223. Hirsch, R. et al. Association of hand and knee osteoarthritis: evidence for a polyarticular disease subset. Ann. Rheum. Dis. 55, 25–29 (1996).

    CAS  PubMed  PubMed Central  Google Scholar 

  224. Dahaghin, S. et al. Prevalence and pattern of radiographic hand osteoarthritis and association with pain and disability (the Rotterdam study). Ann. Rheum. Dis. 64, 682–687 (2005).

    CAS  PubMed  Google Scholar 

  225. Saleh, A. S. et al. Arterial stiffness and hand osteoarthritis: a novel relationship? Osteoarthr. Cartil. 15, 357–361 (2009).

    Google Scholar 

  226. Stankovich, J. et al. Investigation of chromosome 2q in osteoarthritis of the hand: no significant linkage in a Tasmanian population. Ann. Rheum. Dis. 61, 1081–1084 (2002).

    CAS  PubMed  PubMed Central  Google Scholar 

  227. Cooley, H. M. et al. The association between hormonal and reproductive factors and hand osteoarthritis. Maturitas 45, 257–265 (2003).

    CAS  PubMed  Google Scholar 

  228. Szoeke, C. E. I. et al. Factors affecting the prevalence of osteoarthritis in healthy middle-aged women: data from the longitudinal Melbourne Women’s Midlife Health Project. Bone 39, 1149–1155 (2006).

    CAS  PubMed  Google Scholar 

  229. Zhang, Y. et al. Prevalence of symptomatic hand osteoarthritis and its impact on functional status among the elderly: the Framingham Study. Am. J. Epidemiol. 156, 1021–1027 (2002).

    PubMed  Google Scholar 

  230. Hielscher, A. H. et al. Near-infrared diffuse optical tomography. Dis. Markers. 18, 313–337 (2002).

    CAS  PubMed  Google Scholar 

  231. Yuan, Z., Zhang, Q., Sobel, E. & Jiang, H. Comparison of diffusion approximation and higher order diffusion equations for optical tomography of osteoarthritis. J. Biomed. Opt. 14, 054013 (2009).

    PubMed  PubMed Central  Google Scholar 

  232. Yuan, Z., Ieong, F. H., Jiang, H. & Sobel, E. S. Osteoarthritis and psoriatic arthritis: findings in three-dimensional biophotonics imaging. Biomed. Mater. Eng. 24, 3063–3071 (2014).

    PubMed  Google Scholar 

  233. Xi, L. & Jiang, H. Integrated photoacoustic and diffuse optical tomography system for imaging of human finger joints in vivo. J. Biophoton. 9, 213–217 (2016).

    Google Scholar 

  234. Etrych, T. et al. Fluorescence optical imaging in anticancer drug delivery. J. Control. Release. 226, 168–181 (2016).

    CAS  PubMed  Google Scholar 

  235. Werner, S. G. et al. Inflammation assessment in patients with arthritis using a novel in vivo fluorescence optical imaging technology. Ann. Rheum. Dis. 71, 504–510 (2012).

    PubMed  Google Scholar 

  236. Glimm, A. M., Werner, S. G., Burmester, G. R., Backhaus, M. & Ohrndorf, S. Analysis of distribution and severity of inflammation in patients with osteoarthritis compared to rheumatoid arthritis by ICG-enhanced fluorescence optical imaging and musculoskeletal ultrasound: a pilot study. Ann. Rheum. Dis. 75, 566–570 (2016).

    CAS  PubMed  Google Scholar 

  237. Cernohorsky, P. et al. In-situ imaging of articular cartilage of the first carpometacarpal joint using co-registered optical coherence tomography and computed tomography. J. Biomed. Opt. 17, 060501 (2012).

    PubMed  Google Scholar 

  238. Lynch, J. A., Hawkes, D. J. & Buckland-Wright, J. C. Analysis of texture in macroradiographs of osteoarthritic knees using the fractal signature. Phys. Med. Biol. 36, 709–722 (1991).

    CAS  PubMed  Google Scholar 

  239. Wolski, M., Podsiadlo, P., Stachowiak, G. W., Lohmander, L. S. & Englund, M. Differences in trabecular bone texture between knees with and without radiographic osteoarthritis detected by directional fractal signature method. Osteoarthr. Cartil. 18, 684–690 (2010).

    CAS  PubMed  Google Scholar 

  240. Wolski, M., Podsiadlo, P. & Stachowiak, G. W. Directional fractal signature methods for trabecular bone texture in hand radiographs: data from the Osteoarthritis Initiative. Med. Phys. 41, 081914 (2014).

    CAS  PubMed  PubMed Central  Google Scholar 

  241. Mhlanga, J. C., Carrino, J. A., Lodge, M., Wang, H. & Wahl, R. L. 18F-FDG PET of the hands with a dedicated high-resolution PEM system (arthro-PET): correlation with PET/CT, radiography and clinical parameters. Eur. J. Nucl. Med. Mol. Imag. 41, 2337–2345 (2014).

    Google Scholar 

  242. Jonsson, H. et al. The use of digital photographs for the diagnosis of hand osteoarthritis: the AGES-Reykjavik study. BMC Musculoskelet. Disord. 13, 20 (2012).

    PubMed  PubMed Central  Google Scholar 

  243. Marshall, M. et al. Reliability of assessing hand osteoarthritis on digital photographs and associations with radiographic and clinical findings. Arthritis Care Res. (Hoboken). 66, 828–836 (2014).

    PubMed  PubMed Central  Google Scholar 

  244. Paradowski, P. T., Lohmander, L. S. & Englund, M. Natural history of radiographic features of hand osteoarthritis over 10 years. Osteoarthr. Cartil. 18, 917–922 (2010).

    CAS  PubMed  Google Scholar 

  245. Bagge, E., Bjelle, A., Valkenburg, H. A. & Svanborg, A. Prevalence of radiographic osteoarthritis in two elderly European populations. Rheumatol. Int. 12, 33–38 (1992).

    CAS  PubMed  Google Scholar 

  246. Plato, C. C. & Norris, A. H. Osteoarthritis of the hand: age-specific joint-digit prevalence rates. Am. J. Epidemiol. 109, 169–180 (1979).

    CAS  PubMed  Google Scholar 

  247. Yu, D. et al. Annual consultation incidence of osteoarthritis estimated from population-based health care data in England. Rheumatology (Oxford) 54, 2051–2060 (2015).

    Google Scholar 

  248. Bijsterbosch, J. et al. Clustering of hand osteoarthritis progression and its relationship to progression of osteoarthritis at the knee. Ann. Rheum. Dis. 73, 567–572 (2014).

    PubMed  Google Scholar 

  249. Bijsterbosch, J. et al. Clinical and radiographic disease course of hand osteoarthritis and determinants of outcome after 6 years. Ann. Rheum. Dis. 70, 68–73 (2011).

    CAS  PubMed  Google Scholar 

  250. Paradowski, P. T., Lohmander, L. S. & Englund, M. The association between metacarpal ratio, radiographic hand and knee osteoarthritis and its progression after meniscectomy. Osteoarthr. Cartil. 21, 1053–1057 (2013).

    CAS  PubMed  Google Scholar 

  251. Yusuf, E. et al. Association between leptin, adiponectin and resistin and long-term progression of hand osteoarthritis. Ann. Rheum. Dis. 70, 1282–1284 (2011).

    CAS  PubMed  Google Scholar 

  252. Botha-Scheepers, S. et al. Progression of hand osteoarthritis over 2 years: a clinical and radiological follow-up study. Ann. Rheum. Dis. 68, 1260–1264 (2009).

    CAS  PubMed  Google Scholar 

  253. Cvijetić, S., Kurtagić, N. & Ozegović, D. D. Osteoarthritis of the hands in the rural population: a follow-up study. Eur. J. Epidemiol. 19, 687–691 (2004).

    PubMed  Google Scholar 

  254. Hassett, G., Hart, D. J., Doyle, D. V., March, L. & Spector, T. D. The relation between progressive osteoarthritis of the knee and long term progression of osteoarthritis of the hand, hip, and lumbar spine. Ann. Rheum. Dis. 65, 623–628 (2006).

    CAS  PubMed  Google Scholar 

Download references

Acknowledgements

The work of M.M. and K.D. is supported by the Arthritis Research UK Primary Care Centre (20202), and the work of K.D. is partially funded by a Knowledge Mobilisation Research Fellowship (KMRF-2014-03-002) from the UK National Institute for Health Research (NIHR). The work of T.L.V. and F.E.W. is supported by the Arthritis Research UK Centre for Osteoarthritis Pathogenesis (20205 and 21621) and in part by the NIHR Oxford Biomedical Research Centre (the work of F.E.W.). The views expressed are those of the authors and not necessarily those of the UK National Health Service (NHS), the NIHR or the UK Department of Health.

Review criteria

The aim of this Review is to update earlier reviews4,6 published in Nature Reviews Rheumatology with evidence from a search over the past 5 years for new original studies, Cochrane reviews and international guidelines. A search for original articles that examined hand osteoarthritis and were published between 1 January 2012 and 10 October 2017 was performed in MEDLINE. The title and abstracts were searched using the following terms: “osteoarthritis” or “OA” and “hand”, “finger”, “thumb”, “interphalangeal”, “inter phalangeal”, “IPJ”, “metacarpophalangeal”, “metacarpo phalangeal”, “MCP”, “carpometacarpal”, “carpo metacarpal”, “CMC”, “trapezioscaphoid”, “trapezio scaphoid”, “TS”, “erosive”, “nodal” or “node”. All full-text papers and articles in the English language were reviewed. The authors also searched the reference lists of identified articles for further relevant papers.

Author information

Authors and Affiliations

  1. Research Institute for Primary Care and Health Sciences, Arthritis Research UK Primary Care Centre, David Weatherall Building, Keele University, Keele, UK

    Michelle Marshall & Krysia Dziedzic

  2. Arthritis Research UK Centre for Osteoarthritis Pathogenesis, Kennedy Institute of Rheumatology, University of Oxford, Nuffield Department of Orthopaedics,Rheumatology and Musculoskeletal Sciences (NDORMS), Oxford, UK

    Fiona E. Watt & Tonia L. Vincent

Authors
  1. Michelle Marshall
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Fiona E. Watt
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tonia L. Vincent
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Krysia Dziedzic
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

The authors contributed equally to all aspects of the article.

Corresponding author

Correspondence to Krysia Dziedzic.

Ethics declarations

Competing interests

M.M. declares she has no competing interests. F.E.W. declares that she has received clinical study research funding from Astellas and Pfizer. T.L.V. declares that she was a member of a hand osteoarthritis (OA) advisory board for GlaxoSmithKline in 2017. K.D. declares that she is a member of the 2018 EULAR Guidelines Committee for the management of hand OA.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Marshall, M., Watt, F.E., Vincent, T.L. et al. Hand osteoarthritis: clinical phenotypes, molecular mechanisms and disease management. Nat Rev Rheumatol 14, 641–656 (2018). https://doi.org/10.1038/s41584-018-0095-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41584-018-0095-4

This article is cited by

Search

Advanced search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing