The use of digital photographs for the diagnosis of hand osteoarthritis: the AGES-Reykjavik study

BMC Musculoskeletal Disorders

Vilmundur Gudnason⁷  Lenore Launer⁶  Tamara B Harris⁶  Thorvaldur Ingvarsson²  Asbjorn Jonsson³  Gudmundur J Eliasson⁵  Sigurdur Sigurdsson⁴  Gudny Eiriksdottir⁴  Johanna E Sverrisdottir⁴  Thor Aspelund⁷  Gudrun P Helgadottir¹  Helgi Jonsson³ 

[1]University of Iceland, Reykjavik, ICELAND

[2]Akureyri Central Hospital, Akureyri, ICELAND

[3]Landspitalinn University Hospital, University of Iceland, IS-108 Fossvogur, Reykjavik, ICELAND

[4]Icelandic Heart Association, Kopavogur, ICELAND

[5]Roentgen Domus Medica, Reykjavik, ICELAND

[6]National Institute on Aging, Bethesda, MD, USA

[7]Icelandic Heart Association, University of Iceland, Reykjavik, ICELAND

关键词: Photography;    Imaging;    Epidemiology;    Generalized osteoarthritis;    Hand ostearthritis;   

Others  :  1150560
DOI  :  10.1186/1471-2474-13-20

 received in 2011-10-14, accepted in 2012-02-16,  发布年份 2012

【 摘 要 】

Background

The objective of the study was to standardize a method using digital photographs to diagnose and grade hand osteoarthritis (HOA), to compare it with radiographs and clinical examination with regard to prevalence and relation to symptoms, and finally to construct a simple shortened version suitable for use in very large studies, where a global estimate may be preferable.

Methods

High quality photographs with standard distance and hand positioning were analysed for the presence of HOA and subsequently compared with standard radiographs and clinical examination in 381 random participants in the AGES-Reykjavik Study, a large population study. The mean age of the participants was 76 years.

Results

Using the photographic method, the most commonly affected joints were the second DIP joints followed by the third DIP joints and second and third PIP joints. Both interobserver (ICC = 0.83) and intraobserver reading agreements (ICC = 0.89) were acceptable. On comparison with radiography and clinical examination, aggregate scores were significantly correlated (R_s 0.35-0.69), more so in females (R_s 0.53-0.72) than males. Hand pain in males showed very little association with HOA findings by the three methods but all methods showed a comparable moderate association with hand pain in females. The performance of photography in predicting pain on most days for at least a month in females was comparable to that of radiography and clinical examination (AUC 0.63 p = 0.004). Analysis of intermittent pain yielded similar results for in the DIP and PIP joints (OR 3.2-3.3, p < 0.01), but for the CMC1 joints, both radiography (OR 9.0, p < 0.0001), and clinical examination (OR 9.8, p < 0.0001), had higher predictive odds ratios for pain than photography (OR 3.6, p < 0.0001)., A shortened, rapidly performed form of reading photographs also showed a high degree of correlation with the other methods (R_s 0.56-0.82).

Conclusion

High quality hand photographs can be used to diagnose and grade hand osteoarthritis. The method has the advantage of being inexpensive and easy to perform. By using a slightly simplified method of reading, it appears to be highly suitable for use in large studies.

【 授权许可】

   
2012 Jonsson et al; BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

Figure 3.

Figure 4.

Figure 5.

Figure 6.

Figure 7.

Figure 8.

【 参考文献 】

• [1]Jones G, Cooley HM, Bellamy N: A cross-sectional study of the association between Heberden's nodes, radiographic osteoarthritis of the hands, grip strength, disability and pain. Osteoarthr Cartil 2001, 9(7):606-611.
• [2]Fautrel B, Hilliquin P, Rozenberg S, Allaert FA, Coste P, Leclerc A, Rossignol M: Impact of osteoarthritis: results of a nationwide survey of 10.000 patients consulting for OA. Joint Bone Spine 2005, 72(3):235-240.
• [3]Zhang Y, Niu J, Kelly-Hayes M, Chaisson CE, Aliabadi P, Felson DT: Prevalence of symptomatic hand osteoarthritis and its impact on functional status among the elderly: The Framingham Study. Am J Epidemiol 2002, 156(11):1021-1027.
• [4]Jonsson H, Helgadottir GP, Aspelund T, Eiriksdottir G, Sigurdsson S, Siggeirsdottir K, Ingvarsson T, Harris TB, Launer L, Gudnason VG: Hand osteoarthritis severity and severe hip OA are associated with total knee joint replacement independently of BMI. The AGES-Reykjavik Study. Open Rheumatol J 2011, 5:7-12.
• [5]Cooper C, Egger P, Coggon D, Hart DJ, Masud T, Cicuttini F: Generalized osteoarthritis in women: pattern of joint involvement and approaches to definition for epidemiological studies. J Rheumatol 1996, 23:1938-1942.
• [6]Vignon E: Hand osteoarthritis and generalized osteoarthritis: a need for clarification. Osteoarthr Cartil 2000, 8:(Suppl A):22-24.
• [7]Dahaghin S, Bierma-Zeinstra SM, Ginai AZ, Pols HA, Hazes JM, Koes BW: Prevalence and pattern of radiographic hand osteoarthritis and association with pain and disability (the Rotterdam study). Ann Rheum Dis 2005, 64(5):682-687.
• [8]Botha-Scheepers S, Riyazi N, Watt I, Rosendaal FR, Slagboom E, Bellamy N, Breedveld FC, Kloppenburg M: Progression of hand osteoarthritis over 2 years: a clinical and radiological follow-up study. Ann Rheum Dis 2009, 68(8):1260-1264. Epub 2008 Aug 26
• [9]Acheson RM, Collart AB, Greenberg RH, Clemett AR: New Haven survey of joint disease Photographs and other variables in screening for arthritis of the hands. Am J Epidemiol 1969, 90(3):224-235.
• [10]Stern AG, Moxley G, Sudha Rao TP, Disler D, McDowell C, Park M, Schumacher HR: Utility of digital photographs of the hand for assessing the presence of hand osteoarthritis. Osteoarthr Cartil 2004, 12(5):360-365.
• [11]Hirsch R, Guralnik JM, Ling SM, Fried LP, Hochberg MC: The patterns and prevalence of hand osteoarthritis in a population of disabled older women: The Women's Health and Aging Study. Osteoarthr Cartil 2000, 8:(Suppl A):16-21.
• [12]Felson DT, Lawrence RC, Dieppe PA, Hirsch R, Helmick CG, Jordan JM, Kington RS, Lane NE, Nevitt MC, Zhang Y, Sowers M, McAlindon T, Spector TD, Poole AR, Yanovski SZ, Ateshian G, Sharma L, Buckwalter JA, Brandt KD, Fries JF: Osteoarthritis: New insights part 1: The disease and its risk factors. Ann Intern Med 2000, 133(8):635-646.
• [13]Aspelund G, Gunnarsdottir S, Jonsson P, Jonsson H: Hand osteoarthritis in the elderly. Application of clinical criteria. Scand J Rheumatol 1996, 25(1):34-36.
• [14]Jonsson H, Eliasson GJ, Petursson E: Scintigraphic hand osteoarthritis (OA) - prevalence, joint distribution and association with OA at other sites. J Rheumatol 1999, 26:1550-1556.
• [15]Eliasson GJ, Bjorgvinsson E, Jonsson H: Magnetic resonance imaging of the thumb base in severe symptomatic osteoarthritis; a comparison with radiographs and clinical symptoms. Open Arthritis J 2009, 2:1-6.
• [16]Eliasson GJ, Bragason AO, Bjorgvinsson E, Jonsson H: Low level laser therapy (LLLT) of the osteoarthritic CMC1 joint. Report of six patients using magnetic resonance imaging (MRI) to monitor changes after treatment. Scand J Rheumatol 2006, 35:(Suppl 121):50.
• [17]Kellgren JH, Lawrence JS: Radiological assessment of osteo-arthrosis. Ann Rheum Dis 1957, 16(4):494-502.
• [18]Verbruggen G, Veys EM: Numerical scoring systems for the evolution of osteoarthritis of the finger joints. Arthritis Rheum 1996, 39:308-320.
• [19]Jonsson H, Eliasson GJ, Jonsson A, Eiriksdottir G, Sigurdsson S, Aspelund T, Harris TB, Gudnason V: High hand joint mobility is associated with radiological CMC1 osteoarthritis: the AGES-Reykjavik study. Osteoarthr Cartil 2009, 17(5):592-595.
• [20]Eliasson GJ, Verbruggen G, Stefansson SE, Ingvarsson T, Jonsson H: Hand radiology characteristics of patients carrying the T303M mutation in the gene for matrilin-3. Scand J Rheumatol 2006, 35:138-142.
• [21]Jonsson H, Helgadottir GP, Aspelund T, Eiriksdottir G, Sigurdsson S, Ingvarsson T, Harris TB, Launer L, Gudnason V: Hand osteoarthritis in older women is associated with carotid and coronary atherosclerosis: the AGES Reykjavik study. Ann Rheum Dis 2009, 68(11):1696-1700.
• [22]Kornaat PR, Sharma R, van der Geest RJ, Lamb HJ, Kloppenburg M, le Graverand MP, Hellio , Bloem JL, Watt I: Positive association between increased popliteal artery vessel wall thickness and generalized osteoarthritis: is OA also part of the metabolic syndrome? Skeletal Radiol 2009, 38:1147-1151.
• [23]Harris TB, Launer LJ, Eiriksdottir G, Kjartansson O, Jonsson PV, Sigurdsson G, Thorgeirsson G, Aspelund T, Garcia ME, Cotch MF, Hoffman HJ, Gudnason V: Age, Gene/Environment Susceptibility-Reykjavik Study: multidisciplinary applied phenomics. Am J Epidemiol 2007, 165(9):1076-1087.
• [24]Clohisy JC, Carlisle JC, Trousdale R, Kim YJ, Beaule PE, Morgan P, Steger-May K, Schoenecker PL, Millis M: Radiographic evaluation of the hip has limited reliability. Clin Orthop Relat Res 2009, 467(3):666-675.
• [25]Lane NE, Nevitt MC, Genant HK, Hochberg MC: Reliability of new indices of radiographic osteoarthritis of the hand and hip and lumbar disc degeneration. J Rheumatol 1993, 20(11):1911-1918.
• [26]Scott WWJ, Lethbridge-Cejku M, Reichle R, Wigley FM, Tobin JD, Hochberg MC: Reliability of Grading Scales for Individual Radiographic Features of Osteoarthritis of the Knee: The Baltimore Longitudinal Study of Aging Atlas of Knee Osteoarthritis. Invest Radiol 1993, 28(6):501.
• [27]Altman R, Alarcon G, Appelrouth D, Bloch D, Borenstein D, Brandt K, Brown C, Cooke TD, Daniel W, Gray R, et al.: The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hand. Arthritis Rheum 1990, 33(11):1601-1610.
• [28]Marshall M, Dziedzic KS, van der Windt DA, Hay EM: A systematic search and narrative review of radiographic definitions of hand osteoarthritis in population-based studies. Osteoarthr Cartil 2008, 16(2):219-226.
• [29]Niu J, Zhang Y, LaValley M, Chaisson CE, Aliabadi P, Felson DT: Symmetry and clustering of symptomatic hand osteoarthritis in elderly men and women: the Framingham Study. Rheumatol (Oxford) 2003, 42(2):343-348.
• [30]Yusuf E, Nelissen RG, Ioan-Facsinay A, Stojanovic-Susulic V, DeGroot J, van Osch G, Middeldorp S, Huizinga TW, Kloppenburg M: Association between weight or body mass index and hand osteoarthritis: a systematic review. Ann Rheum Dis 2010, 69:761-765.
• [31]Lawrence JS, Bremner JM, Bier F: Osteo-arthrosis. Prevalence in the population and relationship between symptoms and x-ray changes. Ann Rheum Dis 1966, 25(1):1-24.
• [32]Dahaghin S, Bierma-Zeinstra SM, Hazes JM, Koes BW: Clinical burden of radiographic hand osteoarthritis: a systematic appraisal. Arthritis Rheum 2006, 55(4):636-647.
• [33]Jonsson H, Helgadottir GP, Aspelund T, Eiriksdottir G, Sigurdsson S, Siggeirsdottir K, Ingvarsson T, Harris TB, Launer L, Gudnason V: The presence of total knee or hip replacements due to OA enhances the positive association between hand OA and atherosclerosis in females: The AGES-Reykjavik Study. Ann Rheum Dis 2011, in press.
• [34]Jonsson H, Helgadottir GP, Sverrisdottir JE, Eiriksdottir G, Sigurdsson S, Siggeirsdottir S, Ingvarsson T, Harris TB, Launer L, Gudnason V: Photographic scoring is insensitive for monitoring progress of hand osteoarthritis, but side by side comparison of photographs detects progress at 5 year intervals in the elderely. The AGES-Reykjavik Study. Osteoarthr Cartil 2010, 18(Suppl 2):183.