Osteoarthritis of the Finger Epidemiology and Pathogenesis

There are many good reasons to be interested in osteoarthritis of the hand: 1 It is of central importance to osteoarthritis: osteoarthritis of the hand (osteoarthritis of the finger and of the thumb basal joint) is the most common joint site, and affects up to 60% of the general population between the ages of 65 and 75 years. Genetic factors are key: "heritability", as English speakers call it, is estimated to be present in 70% of cases, but trauma and repetitive strain are also often involved, whether in combination with genetic factors or not. 2 Although many women with osteoarthritis do not experience pain, the deformation caused by bony nodules is unsightly and can sometimes cause a great deal of upset to those affected. When there is pain, it is most commonly intermittent, and appears in flares. However, there is a specific sub-group of so-called "erosive" osteoarthritis which can be particularly disabling; these may be difficult to distinguish clinically from psoriatic arthritis. 3 Validated assessment tools are available for monitoring these patients. From a clinical point of view, Dreiser's algo-functional index is simple, reproducible and sensitive to change. From a radiographic point of view, various classifications allow structural changes to be monitored. 4 Finally, the recently published European recommendations for treating osteoarthritis of the hand provide useful guidelines for the systematic management of the condition. In short, all the conditions are present for us to carry out clinical trials in this joint site, as we have already done with knee osteoarthritis and hip osteoarthritis. Osteoarthritis of the hand is the third form of osteoarthritis to be validated for the evaluation of treatment modalities, whether these be pharmacological, educational or surgical. The osteoarthritis section of the French Society for Rheumatology has clearly understood this, and has just launched a randomized study of erosive osteoarthritis of the hand. OSTEOARTHRITIS OF THE FINGER