ABSTRACT

Hand osteoarthritis (OA) is one of the most common musculoskeletal disorder. It is a heteregeneous disease and multiple hand joints are simultaneous involved. It involves the whole joint and leads to loss of cartilage, development of subchondral sclerosis, cysts and osteophytes. It's aetiology is still largely unknown and it is regarded as the consequence of multi-factorial aetiology, which adds to the heterogeneity in OA phenotypes. Some risk factors for hand OA have been recognized. The most important risk factors are age and female gender. Also, mechanical forces, obesity, family history and genes are implicated as risk factors in hand OA. Several sets of criteria are available to classify hand OA. The most well-known is the classification criteria developed by the American College of Rheumatology (ACR). Different hand OA subsets--such as nodal interphalangeal OA, thumb base OA and erosive OA--can be discriminated. Furthermore, the experience of symptoms and the course of the disease differ between patients. Studies that used well-defined study populations with longitudinal follow-up have shown that similarities and differences can be observed in the pathogenesis, epidemiology and risk factors of the various hand OA subsets. Erosive OA in particular, characterized by erosive lesions on radiographical images, has a higher clinical burden and worse outcome than nonerosive hand OA. In hand OA, structural abnormalities can be assessed using radiographs. Imaging modalities such as ultrasonography and magnetic resonance have increased our knowledge of the role of inflammation of the disease.