HOSTAS study “Hand Osteoarthritis in secondary care

Osteoarthritis of the hands is one of the most prevalent musculoskeletal
diseases, leading to pain in and around affected joints, to swelling, stiffness,
deformity and gradual loss of function. However our knowledge concerning hand osteoarthritis is limited.

To increase our insights in 2009 the HOSTAS study was set-up. Nearly 500 patients with hand osteoarthritis are included and are followed at annual intervals.
The objectives of the cohort are:
• To standardize diagnosis, care and follow-up in patients with symptomatic
hand osteoarthritis
• To evaluate disease course, both clinical burden and structural damage, of hand osteoarthritis and to investigate and predict an unfavourable outcome
• To study the utility of imaging (hand radiographs, MRI) in hand osteoarthritis.
• To compare the different subsets of hand osteoarthritis, being nodal and non nodal hand osteoarthritis, interphalangeal osteoarthritis, thumb base osteoarthritis and erosive hand osteoarthritis, with respect to symptoms and signs, disease course and outcome and treatment requirements (splints, intra-articular injections).
• To investigate how MRI features evolve over time and how they relate to radiographic damage.
• To study currently used treatment modalities (“zorgpad artrose”,
• painkillers)
• To study serum, urine and DNA markers in association with current and future symptoms and damage.

Clinical aspects of hand osteoarthritis: are erosions of importance?

W-Y Kwok, thesis defence date September 10 2013

Hand osteoarthritis is highly frequent and results in a considerable clinical burden. Especially functional limitations of the hands affect the lives of patients with hand osteoarthritis unfavourable.  The disease course is highly variable between patients. At the moment the knowledge concerning risk factors associated with disease course is limited

Hand osteoarthritis is a heterogeneous disease comprising of several phenotypes: the phenotype erosive hand osteoarthritis involves severe structural damage at radiographs. Erosions are especially seen in the distal and proximal interphalangeal joints, but can also be seen in the thumb base. Of patients with symptomatic hand osteoarthritis approximately 10 percent have erosive hand osteoarthritis. This phenotype is highly symptomatic. Research performing ultrasonography and MRI have shown that inflammation is often present in hand osteoarthritis, especially in patients with erosive hand osteoarthritis. Synovitis is clinical relevant in hand osteoarthritis, since it is associated with pain in the hand joints.