The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hand.

Authors: Altman R (1,2) , Alarcón G (1,3) , Applerouth D (1) , Bloch D (1,4) , Borenstein D (1,5) , Brandt K (1,6) , Brown C (1,7) , Cooke TD (8,1) , Daniel W (1,3) , Gray R (1) , Greenwald R (9,1) , Hochberg M (1,10) , Howell D (1,11) , Ike R (1,12) , Kapila P (1,11) , Kaplan D (1,13) , Koopman W (1,3) , Longley S (1,14) , McShane DJ (1,4) , Medsger T (1,15) , Michel B (16,1) , Murphy W (17,1) , Osial T (1,15) , Ramsey-Goldman R (1,15) , Rothschild B (1,18) , Stark K (1,13) , Wolfe F (1,19)

Affiliations:

(1) American College of Rheumatology Subcommittee on Criteria for Osteoarthritis (Diagnostic and Therapeutic Criteria Committee of the Council on Research) (2) Miami Veterans Administration Medical Center and University of Miami School of Medicine (3) University of Alabama at Birmingham (4) Stanford University (5) George Washington University Medical Center (6) Indiana University School of Medicine (7) Rush-Presbyterian-St. Luke's Medical Center, Chicago (8) Queen's University, Kingston, Ontario (9) Long Island Jewish Medical Center, New Hyde Park, NY (10) Johns Hopkins University, Baltimore (11) University of Miami (12) University of Michigan, Ann Arbor (13) Downstate Medical Center, Brooklyn, NY (14) University of Florida, Gainesville (15) University of Pittsburgh (16) Rheumaklinik Universitätsspital, Zurich (17) Mallinckrodt Institute of Radiology, Washington University (18) Arthritis Center of Northeast Ohio (19) University of Kansas

Source: Arthritis Rheum. 1990 Nov;33(11):1601-10.

Language: English Countries: Not specified Location: Not specified Correspondence address: R. Altman MD,
American College of Rheumatology, 17 Executive Park Drive NE, Suite 480. Atlanta, GA 30329

Keywords

Hand osteoarthritis

Article abstract

Clinical criteria for the classification of symptomatic idiopathic (primary) osteoarthritis (OA) of the hands were developed from data collected in a multicenter study. Patients with OA were compared with a group of patients who had hand symptoms from other causes, such as rheumatoid arthritis and the spondylarthropathies. Variables from the medical history, physical examination, laboratory tests, and radiographs were analyzed. All patients had pain, aching, or stiffness in the hands. Patients were classified as having clinical OA if on examination there was hard tissue enlargement involving at least 2 of 10 selected joints, swelling of fewer than 3 metacarpophalangeal joints, and hard tissue enlargement of at least 2 distal interphalangeal (DIP) joints. If the patient had fewer than 2 enlarged DIP joints, then deformity of at least 1 of the 10 selected joints was necessary in order to classify the symptoms as being due to OA. The 10 selected joints were the second and third DIP, the second and third proximal interphalangeal, and the trapeziometacarpal (base of the thumb) joints of both hands. Criteria derived using the "classification tree" method were 92% sensitive and 98% specific. The "traditional format" classification method required that at least 3 of these 4 criteria be present to classify a patient as having OA of the hand. The latter sensitivity was 94% and the specificity was 87%. Radiography was of less value than clinical examination in the classification of symptomatic OA of the hands.

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