Age related prevalence of hand osteoarthritis diagnosed by photography (HOASCORE)

Hand osteoarthritis (HOA) is a common condition that is associated with pain and disability. The photographic method was in most aspects comparable to the other techniques concerning pain and disability. Various studies have reported that this photographic scoring system is reliable and also a good indicator of hand OA in a younger population. But none of the studies used this diagnostic method on older aged people. Therefore the present study showed the prevalence of hand OA is higher in women and increases after the age of fifty.

Various studies show evidence of hand photography to evaluate the occurrence and severity of hand osteoarthritis (HOA). This study intended to manifest gender-specific and age prevalences of HOA determined by this technique.

A total of 6343 were estimated for hand osteoarthritis using a 0–3 grade; zero for no evidence, one for possible, two for definite and three for persistent OA per three main sites, proximal interphalangeal joints (PIP), thumb base (CMC1) and distal interphalangeal joints (DIP). The severity of HOA in each case was identified by taking an aggregate score of 0–9.  

The most commonly affected joints were DIP, followed by thumb base and the PIP. As compared to other two sites, definite DIP joint OA began at a younger age and prevalent among females from age 55 to 69, while after 70 fewer gender variations were seen. The PIP joint OA also showed higher prevalence among females from age 60 to 79. Additionally, marked female preponderance was seen in the thumb base OA with an increasing incidence throughout life. The frequency of subjects with no photographic OA evidence falls from 88% to 57% among the age group 40–49 and 50–54 and reduced to 33% in the 70–74 age group with a gradual deterioration after that age. With an OR of 16.6 of having definite OA at the other site, PIP and DIP prevalence presented a strong connection with each other. On the other hand, thumb base showed less marked OR of 2.7 and 2.2 of having a PIP or definite DIP HOA respectively.

The women exhibited a higher prevalence of hand OA in PIP, thumb base and DIP, taken by the photographic HOASCORE process and after the age of fifty, the prevalence raises. These outcomes are in line with those achieved by radiography and clinical examination. The main benefit of the approach is low cost and easy applicability.