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The use of digital photographs for the diagnosis of hand osteoarthritis: the AGES-Reykjavik study.

Jonsson H, Helgadottir GP, Aspelund T, Sverrisdottir JE, Eiriksdottir G, Sigurdsson S, Eliasson GJ, Jonsson A, Ingvarsson T, Harris TB, Launer L, Gudnason V - BMC Musculoskelet Disord (2012)

Bottom Line: On comparison with radiography and clinical examination, aggregate scores were significantly correlated (R(s) 0.35-0.69), more so in females (R(s) 0.53-0.72) than males.Analysis of intermittent pain yielded similar results for in the DIP and PIP joints (OR 3.2-3.3, p < 0.01), but for the CMC1 joints, both radiography (OR 9.0, p < 0.0001), and clinical examination (OR 9.8, p < 0.0001), had higher predictive odds ratios for pain than photography (OR 3.6, p < 0.0001)., A shortened, rapidly performed form of reading photographs also showed a high degree of correlation with the other methods (R(s) 0.56-0.82).By using a slightly simplified method of reading, it appears to be highly suitable for use in large studies.

View Article: PubMed Central - HTML - PubMed

Affiliation: Landspitalinn University Hospital, University of Iceland, IS-108 Fossvogur, Reykjavik, ICELAND. helgi@hi.is

ABSTRACT

Background: The objective of the study was to standardize a method using digital photographs to diagnose and grade hand osteoarthritis (HOA), to compare it with radiographs and clinical examination with regard to prevalence and relation to symptoms, and finally to construct a simple shortened version suitable for use in very large studies, where a global estimate may be preferable.

Methods: High quality photographs with standard distance and hand positioning were analysed for the presence of HOA and subsequently compared with standard radiographs and clinical examination in 381 random participants in the AGES-Reykjavik Study, a large population study. The mean age of the participants was 76 years.

Results: Using the photographic method, the most commonly affected joints were the second DIP joints followed by the third DIP joints and second and third PIP joints. Both interobserver (ICC = 0.83) and intraobserver reading agreements (ICC = 0.89) were acceptable. On comparison with radiography and clinical examination, aggregate scores were significantly correlated (R(s) 0.35-0.69), more so in females (R(s) 0.53-0.72) than males. Hand pain in males showed very little association with HOA findings by the three methods but all methods showed a comparable moderate association with hand pain in females. The performance of photography in predicting pain on most days for at least a month in females was comparable to that of radiography and clinical examination (AUC 0.63 p = 0.004). Analysis of intermittent pain yielded similar results for in the DIP and PIP joints (OR 3.2-3.3, p < 0.01), but for the CMC1 joints, both radiography (OR 9.0, p < 0.0001), and clinical examination (OR 9.8, p < 0.0001), had higher predictive odds ratios for pain than photography (OR 3.6, p < 0.0001)., A shortened, rapidly performed form of reading photographs also showed a high degree of correlation with the other methods (R(s) 0.56-0.82).

Conclusion: High quality hand photographs can be used to diagnose and grade hand osteoarthritis. The method has the advantage of being inexpensive and easy to perform. By using a slightly simplified method of reading, it appears to be highly suitable for use in large studies.

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Related in: MedlinePlus

A receiver operating characteristic (ROC) for "having hand pain sometimes" in relation to aggregate scores of the 10 ACR reference joints the three diagnostic methods in females.
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Figure 6: A receiver operating characteristic (ROC) for "having hand pain sometimes" in relation to aggregate scores of the 10 ACR reference joints the three diagnostic methods in females.

Mentions: Sixteen males (10%) and 92 females (41.4%) reported "pain sometimes". In males there was no association between OA in DIP and PIP joints and either of the pain criteria. There was however, a significant association between intermittent pain in the CMC1 joints and HOA severity measured by radiography (OR 7.4 (1.2-46.4), p < 0.01 and clinical examination 14.3 (1.8-112.4), p < 0.001). The number of individuals in this group was low. In females, intermittent pain in individual joints and joint rows was significantly associated with the severity of OA assessed by all three methods (Figure 6).


The use of digital photographs for the diagnosis of hand osteoarthritis: the AGES-Reykjavik study.

Jonsson H, Helgadottir GP, Aspelund T, Sverrisdottir JE, Eiriksdottir G, Sigurdsson S, Eliasson GJ, Jonsson A, Ingvarsson T, Harris TB, Launer L, Gudnason V - BMC Musculoskelet Disord (2012)

A receiver operating characteristic (ROC) for "having hand pain sometimes" in relation to aggregate scores of the 10 ACR reference joints the three diagnostic methods in females.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3293753&req=5

Figure 6: A receiver operating characteristic (ROC) for "having hand pain sometimes" in relation to aggregate scores of the 10 ACR reference joints the three diagnostic methods in females.
Mentions: Sixteen males (10%) and 92 females (41.4%) reported "pain sometimes". In males there was no association between OA in DIP and PIP joints and either of the pain criteria. There was however, a significant association between intermittent pain in the CMC1 joints and HOA severity measured by radiography (OR 7.4 (1.2-46.4), p < 0.01 and clinical examination 14.3 (1.8-112.4), p < 0.001). The number of individuals in this group was low. In females, intermittent pain in individual joints and joint rows was significantly associated with the severity of OA assessed by all three methods (Figure 6).

Bottom Line: On comparison with radiography and clinical examination, aggregate scores were significantly correlated (R(s) 0.35-0.69), more so in females (R(s) 0.53-0.72) than males.Analysis of intermittent pain yielded similar results for in the DIP and PIP joints (OR 3.2-3.3, p < 0.01), but for the CMC1 joints, both radiography (OR 9.0, p < 0.0001), and clinical examination (OR 9.8, p < 0.0001), had higher predictive odds ratios for pain than photography (OR 3.6, p < 0.0001)., A shortened, rapidly performed form of reading photographs also showed a high degree of correlation with the other methods (R(s) 0.56-0.82).By using a slightly simplified method of reading, it appears to be highly suitable for use in large studies.

View Article: PubMed Central - HTML - PubMed

Affiliation: Landspitalinn University Hospital, University of Iceland, IS-108 Fossvogur, Reykjavik, ICELAND. helgi@hi.is

ABSTRACT

Background: The objective of the study was to standardize a method using digital photographs to diagnose and grade hand osteoarthritis (HOA), to compare it with radiographs and clinical examination with regard to prevalence and relation to symptoms, and finally to construct a simple shortened version suitable for use in very large studies, where a global estimate may be preferable.

Methods: High quality photographs with standard distance and hand positioning were analysed for the presence of HOA and subsequently compared with standard radiographs and clinical examination in 381 random participants in the AGES-Reykjavik Study, a large population study. The mean age of the participants was 76 years.

Results: Using the photographic method, the most commonly affected joints were the second DIP joints followed by the third DIP joints and second and third PIP joints. Both interobserver (ICC = 0.83) and intraobserver reading agreements (ICC = 0.89) were acceptable. On comparison with radiography and clinical examination, aggregate scores were significantly correlated (R(s) 0.35-0.69), more so in females (R(s) 0.53-0.72) than males. Hand pain in males showed very little association with HOA findings by the three methods but all methods showed a comparable moderate association with hand pain in females. The performance of photography in predicting pain on most days for at least a month in females was comparable to that of radiography and clinical examination (AUC 0.63 p = 0.004). Analysis of intermittent pain yielded similar results for in the DIP and PIP joints (OR 3.2-3.3, p < 0.01), but for the CMC1 joints, both radiography (OR 9.0, p < 0.0001), and clinical examination (OR 9.8, p < 0.0001), had higher predictive odds ratios for pain than photography (OR 3.6, p < 0.0001)., A shortened, rapidly performed form of reading photographs also showed a high degree of correlation with the other methods (R(s) 0.56-0.82).

Conclusion: High quality hand photographs can be used to diagnose and grade hand osteoarthritis. The method has the advantage of being inexpensive and easy to perform. By using a slightly simplified method of reading, it appears to be highly suitable for use in large studies.

Show MeSH
Related in: MedlinePlus