The impact of digit-related radiographic osteoarthritis of the hand on grip-strength and upper extremity disability

Clin Orthop Relat Res. 2012 Aug;470(8):2202-8. doi: 10.1007/s11999-012-2253-3. Epub 2012 Jan 26.


Background: Interpreting the impact of hand osteoarthritis (OA) on hand function is complicated owing to the multiple digits and joints in the hand.

Questions/purpose: We determined the impact of digit-related radiographic OA on hand function in patients 65 years or older.

Methods: We evaluated hand radiographs in 196 men and 182 women older than 65 years without shoulder or elbow pain who participated in the Korean Longitudinal Study on Health and Aging. Using the Kellgren and Lawrence criteria, we graded the 15 joints in each hand from 0 to 4 for OA, and evaluated hand function by measuring DASH scores and grip and pinch strength of dominant hands. We performed multiple linear regression analyses to evaluate associations between hand functions and the sum of Kellgren and Lawrence grade of each digit.

Results: The sums of Kellgren and Lawrence grades for thumbs and middle fingers were independently associated with grip strength, and the sums of the Kellgren and Lawrence grades for thumbs and index fingers were independently associated with pinch strength after controlling for age and sex. DASH scores were independently associated with OA of the thumb, or index or middle finger, but not with OA of the ring or small finger.

Conclusions: This study revealed cumulative effects of joint involvement and Kellgren and Lawrence grades of thumb and middle finger OA on grip strength, and thumb and index finger OA on pinch strength. Furthermore, OA of either of three radial digits was associated with more severe upper extremity disabilities.

Level of evidence: Level IV, diagnostic study. See Guidelines for Authors for a complete description of levels of evidence.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Disability Evaluation
  • Disease Progression
  • Female
  • Finger Joint / diagnostic imaging
  • Finger Joint / physiopathology*
  • Humans
  • Male
  • Osteoarthritis / diagnostic imaging
  • Osteoarthritis / physiopathology*
  • Pinch Strength / physiology*
  • Radiography
  • Recovery of Function
  • Thumb / diagnostic imaging
  • Thumb / physiopathology*