BMC Musculoskeletal Disorders (Feb 2012)

The use of digital photographs for the diagnosis of hand osteoarthritis: the AGES-Reykjavik study

  • Jonsson Helgi,
  • Helgadottir Gudrun P,
  • Aspelund Thor,
  • Sverrisdottir Johanna E,
  • Eiriksdottir Gudny,
  • Sigurdsson Sigurdur,
  • Eliasson Gudmundur J,
  • Jonsson Asbjorn,
  • Ingvarsson Thorvaldur,
  • Harris Tamara B,
  • Launer Lenore,
  • Gudnason Vilmundur

DOI
https://doi.org/10.1186/1471-2474-13-20
Journal volume & issue
Vol. 13, no. 1
p. 20

Abstract

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Abstract Background The objective of the study was to standardize a method using digital photographs to diagnose and grade hand osteoarthritis (HOA), to compare it with radiographs and clinical examination with regard to prevalence and relation to symptoms, and finally to construct a simple shortened version suitable for use in very large studies, where a global estimate may be preferable. Methods High quality photographs with standard distance and hand positioning were analysed for the presence of HOA and subsequently compared with standard radiographs and clinical examination in 381 random participants in the AGES-Reykjavik Study, a large population study. The mean age of the participants was 76 years. Results Using the photographic method, the most commonly affected joints were the second DIP joints followed by the third DIP joints and second and third PIP joints. Both interobserver (ICC = 0.83) and intraobserver reading agreements (ICC = 0.89) were acceptable. On comparison with radiography and clinical examination, aggregate scores were significantly correlated (Rs 0.35-0.69), more so in females (Rs 0.53-0.72) than males. Hand pain in males showed very little association with HOA findings by the three methods but all methods showed a comparable moderate association with hand pain in females. The performance of photography in predicting pain on most days for at least a month in females was comparable to that of radiography and clinical examination (AUC 0.63 p = 0.004). Analysis of intermittent pain yielded similar results for in the DIP and PIP joints (OR 3.2-3.3, p p p p s 0.56-0.82). Conclusion High quality hand photographs can be used to diagnose and grade hand osteoarthritis. The method has the advantage of being inexpensive and easy to perform. By using a slightly simplified method of reading, it appears to be highly suitable for use in large studies.

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