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Rheumatology Advance Access originally published online on October 15, 2007
Rheumatology 2007 46(11):1723-1728; doi:10.1093/rheumatology/kem253
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© The Author 2007. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Hand and wrist problems in general practice—patient characteristics and factors related to symptom severity

M. N. Spies-Dorgelo1,2, D. A. W. M. van der Windt1,2,3, H. E. van der Horst1,2, A. P. A. Prins4 and W. A. B. Stalman1,2

1Department of General Practice, 2EMGO Institute, VU University Medical Center, Amsterdam, The Netherlands, 3Primary Care Musculoskeletal Research Centre, Keele University, Keele, UK and 4Jan van Breemen Institute, Amsterdam, The Netherlands

Correspondence to: M. N. Spies-Dorgelo, EMGO Institute, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands. E-mail: mn.spies{at}vumc.nl


  Abstract

Objectives. Hand and wrist problems are common, but little is known about characteristics of patients consulting the general practitioner (GP) for these problems. The objectives are: (i) to describe wrist and hand problems presented to the GP in terms of severity of symptoms, and their impact on physical, emotional and social functioning; (ii) to describe patient and disease characteristics across different diagnostic categories; and (iii) to study factors related to the severity of hand or wrist problems.

Methods. Patients consulting their GP with hand or wrist problems were sent a questionnaire containing questions on socio-demographic variables, characteristics of the complaint, physical activity and psychosocial factors. The GP recorded information on symptoms, signs and medical diagnosis. We studied the cross-sectional association between a variety of factors and severity of hand or wrist problems, using the Symptom Severity Scale as the outcome measure.

Results. Mean age of the 267 participants was 49.3 yrs and 74% were female. The three most frequently recorded diagnoses were osteoarthritits (17%), tenosynovitis (16%) and nerve entrapment (12%). The characteristics of patients varied slightly across diagnostic categories. Patients who did not have paid work, had longer duration of symptoms, diagnosis of entrapment, higher pain intensity, higher body mass index and higher scores on worrying reported significantly higher scores on severity of hand or wrist problems (P-value <0.10).

Conclusion. Primary care patients with hand or wrist problems report pain and reduced function. Impact on other aspects of perceived health is limited. Severity seems to be associated with socio-demographic, physical and psychosocial factors, more than with medical diagnosis.

KEY WORDS: Primary care, Hand or wrist problems, Diagnosis, Cross-sectional study, Pain

Submitted 4 May 2007; revised version accepted 17 August 2007.
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