Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2009 Jan;68(1):8-17.
doi: 10.1136/ard.2007.084772. Epub 2008 Feb 4.

EULAR evidence-based recommendations for the diagnosis of hand osteoarthritis: report of a task force of ESCISIT

W Zhang  1 , M Doherty, B F Leeb, L Alekseeva, N K Arden, J W Bijlsma, F Dincer, K Dziedzic, H J Hauselmann, P Kaklamanis, M Kloppenburg, L S Lohmander, E Maheu, E Martin-Mola, K Pavelka, L Punzi, S Reiter, J Smolen, G Verbruggen, I Watt, I Zimmermann-Gorska; ESCISIT
Affiliations
Review

EULAR evidence-based recommendations for the diagnosis of hand osteoarthritis: report of a task force of ESCISIT

W Zhang et al. Ann Rheum Dis. 2009 Jan.

Abstract

Objectives: To develop evidence-based recommendations for the diagnosis of hand osteoarthritis (OA).

Methods: The multidisciplinary guideline development group, representing 15 European countries, generated 10 key propositions regarding diagnosis using a Delphi consensus approach. For each recommendation, research evidence was searched for systematically. Whenever possible, the sensitivity, specificity and likelihood ratio (LR) were calculated; relative risk and odds ratios were estimated for risk factors for hand OA. Quality of evidence was categorised using the European League Against Rheumatism (EULAR) hierarchy, and strength of recommendation was assessed by the EULAR visual analogue scale.

Results: Diagnostic topics included clinical manifestations, radiographic features, subgroups, differential diagnosis, laboratory tests, risk factors and comorbidities. The sensitivity, specificity and LR varied between tests depending upon the cut-off level, gold standard and controls. Overall, no single test could be used to define hand OA on its own (LR <10) but a composite of the tests greatly increased the chance of the diagnosis. The probability of a subject having hand OA was 20% when Heberden nodes alone were present, but this increased to 88% when in addition the subject was over 40 years old, had a family history of nodes and had joint space narrowing in any finger joint.

Conclusion: Ten key recommendations for diagnosis of hand OA were developed using research evidence and expert consensus. Diagnosis of hand OA should be based on assessment of a composite of features.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

LinkOut - more resources