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Rheumatology Advance Access published online on February 16, 2005
Rheumatology, doi:10.1093/rheumatology/keh573
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© British Society for Rheumatology 2005; all rights reserved
Received October 21, 2004
Accepted January 11, 2005

Concise Report

Clinical characteristics of an anatomical hand index measured in patients with rheumatoid arthritis as a potential outcome measure

J. Highton 1*, V. Markham 1, T. C. A. Doyle 2, and P. L. Davidson 3

1 Department of Medicine, University of Otago Medical School, Dunedin, New Zealand
2 Department of Radiology, University of Otago Medical School, Dunedin, New Zealand
3 Department of Preventive and Social Medicine, University of Otago Medical School, Dunedin, New Zealand

* To whom correspondence should be addressed.
J. Highton, E-mail: john.highton{at}stonebow.otago.ac.nz


  Abstract

Objectives. To determine the clinical characteristics of an anatomical hand index previously reported as a potential measure of joint deformity and outcome in patients with rheumatoid arthritis.

Methods. The hand index (open hand span - closed hand span/lateral height of the hand) was measured in a cross-sectional study of 145 out-patients with rheumatoid arthritis with disease durations 0-55 yr. Subsets of patients were restudied at mean follow-ups of approximately 9 months and 4 yr.

Results. The hand index fell gradually with disease duration. Correlations were demonstrated with the Sharp index (r = - 0.39, P = 0.000) and to a lesser extent with disease activity score (r = - 0.28, P = 0.001). At 260 ± 115 days the hand index worsened by 0.09 units (P = 0.09, NS). At 51.6 ± 5.4 months the index showed a fall from 1.96 ± 0.73 to 1.61 ± 0.65 (P = 0.000). During the same interval the Sharp index increased from 60 ± 68 to 80 ± 71 (P = 0.000).

Conclusions. Measurement of simple hand dimensions can demonstrate worsening of hand deformity with time in patients with rheumatoid arthritis. We suggest that more sophisticated analysis of digital hand images, as used in our original study, might yield additional information and increase the sensitivity of an anatomical hand index as an outcome measure in rheumatoid arthritis.

Keywords: Rheumatoid arthritis; Outcome assessment.
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P. M. Johnsson and K. Eberhardt
Hand deformities are important signs of disease severity in patients with early rheumatoid arthritis
Rheumatology, November 1, 2009; 48(11): 1398 - 1401.
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