Defining osteoarthritis ofthehandfor epidemiological studies: TheChingford Study

Objectives-To explore therelative merits ofclinical andradiological examination in defining handosteoarthritis (OA)forepidemiological purposes. Methods-Atotal of976womenaged45-64 yearswereselected fromthegeneral population andunderwent a structured interview, clinical examination of the handjoints andradiography ofthehands andknees.Theinter-relationship ofthe clinical and radiological findings was examined, andalsotheassociation ofeach withhandsymptomsandthepresence of kneeOA. Results-Clinical andradiographic signs ofhandOA generally correlated witheach other, andeachwasassociated withhand symptomsto a similar degree.When analysed incombination, theywereonly marginally better atpredicting symptoms thanwhentested individually. However, whentheywereexaminedinrelation to radiographic features ofkneeOA, there was a significantly stronger association withradiographic features ofhandOA thanwithclinical features. Conclusions-Hand radiology provides a better overall assessment ofosteoarthritis thanphysical examination oftheinterphalangeal joints or carpo-metacarpal joint; insituations whereradiology isnot available clinical examination isaviable substitute.