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In this study, the associations of photographic hand osteoarthritis (OA) with radiographic OA and clinical features were examined to explore the construct validity of hand photography as an indicator of hand OA. An example of a hand photograph and its corresponding radiographic image is shown.

In this study, the associations of photographic hand osteoarthritis (OA) with radiographic OA and clinical features were examined to explore the construct validity of hand photography as an indicator of hand OA. An example of a hand photograph and its corresponding radiographic image is shown.

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Objective To investigate the reliability and construct validity of an atlas for grading hand osteoarthritis (OA) on photographs in a separate younger community-dwelling population than the development cohort.Methods Participants were community-dwelling adults (ages ≥50 years) in North Staffordshire, UK with hand pain or hand problems in the last ye...

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... associations of photographic hand OA with radio- graphic OA and clinical features were examined to ex- plore the construct validity of hand photography as an indicator of hand OA (example in Figure 1). For each hand joint and joint group, the frequency of 1) mild (K/L score of 2) and moderate to severe (K/L score 3) radiographic OA and 2) the number of clinical features present on the hand examination were determined for each photographic hand OA grade (range 0 -3). ...

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... In 2012, the Age, Gene/Environment Susceptibility -Reykjavik (AGES-Reykjavik) photographic atlas was developed as a formal method for scoring hand photographs for OA [9]. It has been shown to be reliable and associated cross-sectionally with radiographic and clinical OA [10,11] and shows age-related prevalence trends that are comparable to those seen for clinical and radiographic OA [12]. However, it is not known whether this method is valid in comparison to the progression of radiographic OA and the increased presence of clinical features determined from a physical examination. ...
... Reliability of using the photographic scoring system has previously been established [11], thus reliability was undertaken at 7-years to ensure that this hadn't markedly changed. The inter-rater reliability of the scoring of photographic hand Fig. 1 An example of the photographic hand images obtained at baseline and 7 years for a participant OA at 7 years was assessed across all participants using intra-class correlation coefficients (ICC), using 2-way random effects models with absolute agreement, for the 10 hand joints and three joint groups. ...
... Two a priori hypotheses were set regarding these correlations at the joint and joint group level: 1) Change in photographic hand OA scores for each joint was expected to correlate more closely with the change in the number of clinical features than with the change in radiographic OA grade. 2) Correlations would be the same or slightly lower than was achieved at baseline for cross-sectional construct validity in each hand joint and joint group [11]. ...
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Background: To determine the longitudinal construct validity of assessing hand OA progression on digital photographs over 7 years compared with progression determined from radiographs, clinical features and change in symptoms. Methods: Participants were community-dwelling older adults (≥50 years) in North Staffordshire, UK. Standardized digital hand photographs were taken at baseline and 7 years, and hand joints graded for OA severity using an established photographic atlas. Radiographic hand OA was assessed using the Kellgren and Lawrence grading system. Hand examination determined the presence of nodes, bony enlargement and deformity. Symptoms were reported in self-complete questionnaires. Radiographic and clinical progression and change in symptoms were compared to photographic progression. Differences were examined using analysis of covariance and Chi-Square tests. Results: Of 253 individuals (61% women, mean age 63 years) the proportion with photographic progression at the joint and joint group-level was higher in individuals with radiographic or clinical progression compared to those without, although differences were not statistically significant. At the person-level, those with moderate photographic progression over 7 years had significantly higher summed radiographic and clinical scores (adjusted for baseline scores) compared to those with no or mild photographic progression. Similar findings were observed for change in symptoms, although differences were small and not statistically significant. Conclusion: Assessing hand OA on photographs shows modest longitudinal construct validity over 7 years compared with change in radiographic and clinical hand OA at the person-level. Using photographs to assess overall long-term change in a person with hand OA may be a reasonable alternative when hand examinations and radiographs are not feasible.
... Among the possible caveats of this study are the methods used for diagnosing hand osteoarthritis with photography and using TKR's after exclusion of other causes such as inflammatory arthritis or fractures as a marker of severe knee OA. The photographic method for diagnosing hand OA has been validated in other populations [28], and TKR's are considered as a sensitive marker of severe knee OA, mainly limited by unequal access to operation in different populations. In Iceland, the health care system is socialized and previous Icelandic studies have not found any association between the prevalence of TKR's and education or occupational classes, indicating equal access [14,29]. ...
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To investigate the association between osteoarthritis (OA) and microvascular pathology, we examined the relationship between retinal microvascular caliber and osteoarthritis of the hand and knee in an elderly population. The AGES-Reykjavik is a population-based, multidisciplinary longitudinal cohort study of aging. Retinal vessel caliber, hand osteoarthritis and total knee joint replacements due to OA were examined in 4757 individuals (mean age 76 ± 5 years; 57% female). Incident knee joint replacements during 5-year follow-up (n = 2961, mean age 75 ± 5 years; 58% female) were also assessed. Logistic regression analysis, adjusting for age, sex, and body mass index, showed an association between narrow arteriolar caliber and hand OA, as well as knee replacement. After adjustment for other covariates, including statin therapy, this association was significant for both hand OA in men and women [OR 1.10(1.03–1.17), p < 0.01] (per unit standard deviation decrease in CRAE) and TKR prevalence [OR 1.15 (1.01–1.32), p = 0.04], especially for men [OR 1.22 (1.00–1.51) p = 0.04] and also for incident TKRs in men [OR 1.50 (1.07–2.10), p = 0.04]. Narrow venular caliber was associated with hand OA in women [OR 1.10 (1.01–1.21), p = 0.03]. Retinal arterial narrowing in hand and knee OA is present in males as well as females. Venular narrowing in hand OA in women was an unexpected finding and is in contrast with the venular widening usually observed in cardiovascular diseases.
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... The photographic method was in most aspects comparable to the other methods in relation to pain and disability. Subsequent studies have indicated that this method of photographic scoring system is reliable and also a good indicator of hand OA in a younger population and offers a feasible alternative to physical examination and radiography [12]. ...
... An aggregate score of 0-9 was thus obtained. A score of 4 or more was chosen to reflect severe hand OA in accordance with previous studies [8,12] Statistics were calculated using SPSS version 22. Chisquare and the Mantel Haenszel odds ratio estimate was used to calculate gender prevalence differences and the likelihood of having definite OA at a second site if participants had definite OA at one site. ...
... In addition, the simplified HOASCORE showed a high degree of correlation with aggregate scores of both radiology and clinical examination [8]. These findings have been corraborated in a younger symptomatic population from the UK [12]. The age related prevalences obtained by photograph scoring in the current study show age related patterns that are comparable to clinical and radiographic studies, such as the marked female preponderance in the postmenopausal age groups and in the thumb base. ...
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Background: Hand photography has been used in a number of studies to determine the presence and severity of hand osteoarthritis (HOA). The aim of this study was to present age and gender specific prevalences of HOA diagnosed by this method. Methods: Six thousand three hundred forty three photographs (from 3676 females and 2667 males aged 40-96) were scored for hand osteoarthritis by a 0-3 grade (0 = no evidence of OA, 1 = possible OA, 2 = definite OA and 3 = severe OA) for each of the three main sites, distal interphalangeal joints (DIP), proximal interphalangeal joints (PIP) and thumb base (CMC1). An aggregate score of 0-9 was thus obtained (HOASCORE) to reflect the severity of HOA in each case. Results: DIP joints were most commonly affected, followed by the thumb base and the PIP joints. Having definite DIP joint OA starts at a younger age compared with the other two sites, and there is a marked female preponderance in the age groups from 55 to 69, but after 70 the gender differences are less marked and the prevalence is fairly stable. PIP joint prevalence also indicates a female preponderance from 60 to 79. Thumb base OA has a more marked female preponderance and a rising prevalence thoughout life. The prevalence of individuals with no evidence of photographic OA (HOASCORE = 0) drops from 88% to 57% between the age categories 40-49 and 50-54 and decreased to 33% in the 70-74 age group with a slower decline after that age. DIP and PIP prevalence were strongly associated with each other with an OR of 16.6(12.8-21.5),p < 0.001 of having definite OA at the other site. This was less marked for the thumb base with an OR of 2.2(1.8-2.7, p < 0.001), and 2.7(2.0-3.5, p < 0.001) of having definite DIP or PIP HOA respectively. Conclusions: The prevalence of hand OA in DIP, PIP and thumb base joints obtained by the photographic HOASCORE method is higher in women and increases after the age of fifty. These results are in line with those obtained by clinical examination and radiography. The advantage of the method lies in easy applicability and low cost.
... This study was later extended to see if the atlas would be as useful for younger populations. The atlas and method created in the Iceland study was used with patients in Keele, UK and results of the study were published in 2013 [11]. In the study, the atlas developed was used to assess 558 participants who were community dwelling adults 50 years of age and older. ...
... In the study, the atlas developed was used to assess 558 participants who were community dwelling adults 50 years of age and older. The scoring system was shown to be reliable and a good indicator of hand OA [11]. ...
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Objective The RADIANT study aimed to investigate the efficacy and safety of a complementary medicine supplement combination in people with hand osteoarthritis (HOA). Method This was an internet-based, double-blind, randomised, placebo-controlled trial. Participants aged over 40 years with symptomatic HOA with radiographic confirmation (Kellgren Lawrence grade ≥ 2) throughout Australia were recruited and randomly assigned (1:1) to receive either a supplement combination composed of Boswellia serrata extract 250 mg/day, pine bark extract 100 mg/day, methylsulfonylmethane 1500 mg/day and curcumin 168 mg/day or placebo for 12 weeks. The primary outcome was change in hand pain assessed using a visual analogue scale (VAS 0-100) from baseline to week 12. A range of secondary outcomes and additional measures were recorded. Adverse events were monitored weekly. Results One hundred and six participants were included with mean age 65.6 years and 81% were women. 45% of the participants were graded as KLG 4, 40% KLG 3 and 39 (37%) had erosive OA. There was no significant difference in pain VAS reduction between groups. The adjusted between group difference in means (95%CI) was 5.34 (-2.39 to 13.07). Five participants (10%) in the supplement combination group discontinued study treatment due to AE versus four participants (7%) in the placebo group. Conclusion There were no significant differences in symptomatic relief between the two groups over 12 weeks. These findings do not support the use of the supplement combination for treating hand pain in people with HOA. Registration Prospectively registered (Australian New Zealand Clinical Trials Registry ACTRN12619000835145, 31/05/2019).