The prevalence of symptomatic hand osteoarthritis in Tehran: Community-oriented program for Control of Rheumatic Diseases- COPCORD


Abstract: Osteoarthritis is the most common form of arthritis in the world. This study presents the evidence on the prevalence of symptomatic hand osteoarthritis in urban community. To add to the evidence on the prevalence of symptomatic hand osteoarthritis in urban community. Methods: Inhabitants (age≥15 yrs) in 22 randomly selected districts (Tehran) participated in a Community-Oriented Program for Control of Rheumatic Diseases (COPCORD) evaluating major rheumatic disorders, including osteoarthritis. Eventually, 10, 291 inhabitants completed a Questionnaire (75% response-rate). Trained interviewers asked participants whether they had had any pain, swelling, tenderness, or morning stiffness in the right/ left hand during previous seven days. Participants underwent a complete physical examination if they had any musculoskeletal complaint or extraarticular manifestation of rheumatic disease. Osteoarthritis was defined as presence of palpable nodules (Heberden’s/ Bouchard’s nodes, CMC1’s squaring), pain, tenderness, swelling, or a combination of them on that joint (DIP-PIP-MCP-CMC1). Clinical hand osteoarthritis was positive if at least one joint showed osteoarthritis. Results: Symptomatic hand osteoarthritis was present in 2.8%(CI; 2.3-3.4) (52.6% female, mean age; 37.1±16.3). Prevalence was higher in females (4.3% vs. 1.3%, p=0.000) and increased with age (0.1% in people <30 versus 23% in people >70, p=0.000). The most common signs in the DIP, PIP and CMC1 joints were bony enlargement, followed by tenderness and pain on movement. Conclusions: our study confirms the evidence of high prevalence of symptomatic hand osteoarthritis in an urban community. The prevalence, pattern of hand joints involvement and relationship with age and sex in this study performed in an Eastern community resemble those in Westerners, which calls for further attention by appropriate services. Keywords: Hand, osteoarthritis, prevalence, epidemiology rheumatic disease