Generalised Osteoarthritis Exacerbates Pain and Disability in Hand Osteoarthritis: A Single-Centre Retrospective Study

全身性骨关节炎加剧手部骨关节炎的疼痛和功能障碍:一项单中心回顾性研究

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Abstract

BACKGROUND: Hand osteoarthritis (HOA) is common in older adults and often coexists with osteoarthritis (OA) in other joints. OBJECTIVE: To determine whether HOA occurs in isolation or as part of generalised OA, and to assess the impact of coexisting joint involvement on pain and functional outcomes. MATERIALS AND METHODS: This retrospective study included 75 patients with radiographically confirmed HOA seen between January and June 2019. Patients were classified as having isolated HOA (n = 31) or generalised OA (n = 44). Pain and function were assessed using VAS, FIHOA, and HAQ. Non-parametric tests with p-values and 95% confidence intervals were used. RESULTS: Isolated HOA was present in 41% of patients, while 59% had OA in additional joints-most commonly the knees (68%), spine (55%), and hips (32%). Patients with generalised OA reported slightly higher pain (median VAS 61 mm vs. 61 mm; difference 0 mm, 95% CI: -26 to 34; p = 0.55) and greater functional impairment (median HAQ 1.0 vs. 0.75; difference 0.25, 95% CI: 0.0 to 0.5; p = 0.10), though differences were not statistically significant. Significant positive correlations were observed between FIHOA, VAS, and HAQ, strongest between FIHOA and VAS in generalised OA (rho = 0.75, 95% CI: 0.58 to 0.86; p < 0.001). CONCLUSION: HOA frequently coexists with OA in other joints and may contribute to greater pain and disability, highlighting the need for comprehensive assessment.

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