2023 EULAR classification criteria for hand osteoarthritis

Haugen, Ida K.; Felson, David T.; Abhishek, Abhishek; Berenbaum, Francis; Bierma-Zeinstra, Sita; Dziedzic, Krysia S.; Edwards, John James; Englund, Martin; Hermann-Eriksen, Merete; Herrero-Beaumont, Gabriel; Hill, Catherine; Ishimori, Mariko L.; Jonsson, Helgi; Karjalainen, Teemu; Leung, Ying Ying; Maheu, Emmanuel; Mallen, Christian D.; Marshall, Michelle; Moe, Rikke H.; Ramonda, Roberta; Ritschl, Valentin; Ritt, Marco Jpf; Stamm, Tanja A.; Szekanecz, Zoltan; van der Giesen, Florus; van de Stadt, Lotte A.; van der Meulen, Coen; Wittoek, Ruth; Greibrokk, Elsie; Laheij, Hellen; Kloppenburg, Margreet

Abstract

Objectives The objective of this study is to develop classification criteria for overall hand osteoarthritis (OA), interphalangeal OA and thumb base OA based on self-reported data and radiographic features.

Methods The classification criteria sets were developed in three phases. In phase 1, we identified criteria that discriminated hand OA from controls. In phase 2, we used a consensus-based decision analysis approach to derive a clinician-based evaluation of the relative importance of the criteria. In phase 3, we refined the scoring system, determined the cut-offs for disease classification and compared the sensitivity and specificity of the European Alliance of Associations for Rheumatology (EULAR) criteria with the 1990 American College of Rheumatology (ACR) criteria.

Results In persons with hand symptoms and no other disease (including psoriasis) or acute injury that can explain the hand symptoms (mandatory criteria), hand OA can be classified based on age, duration of morning stiffness, number of joints with osteophytes and joint space narrowing, and concordance between symptoms and radiographic findings. Using a sum of scores based on each diagnostic element, overall hand OA can be classified if a person achieves 9 or more points on a 0–15 scale. The cut-off for interphalangeal OA and thumb base OA is 8 points. While the EULAR criteria demonstrated better sensitivity than the ACR criteria in the phase 1 data set, the performance of the two criteria sets was similar in two external cohorts.

Conclusions International experts developed the EULAR criteria to classify overall hand OA, interphalangeal OA and thumb base OA in clinical studies using a rigorous methodology.

Citation

Haugen, I. K., Felson, D. T., Abhishek, A., Berenbaum, F., Bierma-Zeinstra, S., Dziedzic, K. S., Edwards, J. J., Englund, M., Hermann-Eriksen, M., Herrero-Beaumont, G., Hill, C., Ishimori, M. L., Jonsson, H., Karjalainen, T., Leung, Y. Y., Maheu, E., Mallen, C. D., Marshall, M., Moe, R. H., Ramonda, R., …Kloppenburg, M. (2024). 2023 EULAR classification criteria for hand osteoarthritis. Annals of the Rheumatic Diseases, https://doi.org/10.1136/ard-2023-225073

• Journal Article Type: Article
• Acceptance Date: May 3, 2024
• Online Publication Date: May 31, 2024
• Publication Date: May 31, 2024
• Deposit Date: Jul 20, 2024
• Publicly Available Date: Jul 23, 2024
• Journal: Annals of the rheumatic diseases
• Print ISSN: 0003-4967
• Electronic ISSN: 1468-2060
• Publisher: BMJ Publishing Group
• Peer Reviewed: Peer Reviewed
• DOI: https://doi.org/10.1136/ard-2023-225073
• Keywords: Epidemiology, Osteoarthritis, Patient Reported Outcome Measures
• Public URL: https://nottingham-repository.worktribe.com/output/36280932
• Publisher URL: https://ard.bmj.com/content/early/2024/05/31/ard-2023-225073