The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hand

Roy D Altman, G. Alarcón, D. Appelrouth, D. Bloch, D. Borenstein, K. Brandt, C. Brown, T. D. Cooke, W. Daniel, R. Gray, R. Greenwald, M. Hochberg, D. Howell, R. Ike, P. Kapila, D. Kaplan, W. Koopman, S. Longley, D. J. McShane, T. MedsgerB. Michel, W. Murphy, T. Osial, R. Ramsey-Goldman, B. Rothschild, K. Stark, F. Wolfe

Research output: Contribution to journalArticle

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Abstract

Clinical criteria for the classification of symptomatic idiopathic (primary) osteoarthritis (OA) of the hands were developed from data collected in a multicenter study. Patients with OA were compared with a group of patients who had hand symptoms from other causes, such as rheumatoid arthritis and the spondylarthropathies. Variables from the medical history, physical examination, laboratory tests, and radiographs were analyzed. All patients had pain, aching, or stiffness in the hands. Patients were classified as having clinical OA if on examination there was hard tissue enlargement involving at least 2 of 10 selected joints, swelling of fewer than 3 metacarpophalangeal joints, and hard tissue enlargement of at least 2 distal interphalangeal (DIP) joints. If the patient had fewer than 2 enlarged DIP joints, then deformity of at least 1 of the 10 selected joints was necessary in order to classify the symptoms as being due to OA. The 10 selected joints were the second and third DIP, the second and third proximal interphalangeal, and the trapeziometacarpal (base of the thumb) joints of both hands. Criteria derived using the "classification tree" method were 92% sensitive and 98% specific. The "traditional format" classification method required that at least 3 of these 4 criteria be present to classify a patient as having OA of the hand. The latter sensitivity was 94% and the specificity was 87%. Radiography was of less value than clinical examination in the classification of symptomatic OA of the hands.

Original languageEnglish (US)
Pages (from-to)1601-1610
Number of pages10
JournalArthritis and Rheumatism
Volume33
Issue number11
StatePublished - Nov 1990

Fingerprint

Osteoarthritis
Hand
Joints
Hand Joints
Metacarpophalangeal Joint
Spondylarthropathies
Thumb
Radiography
Multicenter Studies
Physical Examination
Rheumatoid Arthritis
Pain

ASJC Scopus subject areas

  • Immunology
  • Rheumatology

Cite this

Altman, R. D., Alarcón, G., Appelrouth, D., Bloch, D., Borenstein, D., Brandt, K., ... Wolfe, F. (1990). The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hand. Arthritis and Rheumatism, 33(11), 1601-1610.

The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hand. / Altman, Roy D; Alarcón, G.; Appelrouth, D.; Bloch, D.; Borenstein, D.; Brandt, K.; Brown, C.; Cooke, T. D.; Daniel, W.; Gray, R.; Greenwald, R.; Hochberg, M.; Howell, D.; Ike, R.; Kapila, P.; Kaplan, D.; Koopman, W.; Longley, S.; McShane, D. J.; Medsger, T.; Michel, B.; Murphy, W.; Osial, T.; Ramsey-Goldman, R.; Rothschild, B.; Stark, K.; Wolfe, F.

In: Arthritis and Rheumatism, Vol. 33, No. 11, 11.1990, p. 1601-1610.

Research output: Contribution to journalArticle

Altman, RD, Alarcón, G, Appelrouth, D, Bloch, D, Borenstein, D, Brandt, K, Brown, C, Cooke, TD, Daniel, W, Gray, R, Greenwald, R, Hochberg, M, Howell, D, Ike, R, Kapila, P, Kaplan, D, Koopman, W, Longley, S, McShane, DJ, Medsger, T, Michel, B, Murphy, W, Osial, T, Ramsey-Goldman, R, Rothschild, B, Stark, K & Wolfe, F 1990, 'The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hand', Arthritis and Rheumatism, vol. 33, no. 11, pp. 1601-1610.
Altman RD, Alarcón G, Appelrouth D, Bloch D, Borenstein D, Brandt K et al. The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hand. Arthritis and Rheumatism. 1990 Nov;33(11):1601-1610.
Altman, Roy D ; Alarcón, G. ; Appelrouth, D. ; Bloch, D. ; Borenstein, D. ; Brandt, K. ; Brown, C. ; Cooke, T. D. ; Daniel, W. ; Gray, R. ; Greenwald, R. ; Hochberg, M. ; Howell, D. ; Ike, R. ; Kapila, P. ; Kaplan, D. ; Koopman, W. ; Longley, S. ; McShane, D. J. ; Medsger, T. ; Michel, B. ; Murphy, W. ; Osial, T. ; Ramsey-Goldman, R. ; Rothschild, B. ; Stark, K. ; Wolfe, F. / The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hand. In: Arthritis and Rheumatism. 1990 ; Vol. 33, No. 11. pp. 1601-1610.
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abstract = "Clinical criteria for the classification of symptomatic idiopathic (primary) osteoarthritis (OA) of the hands were developed from data collected in a multicenter study. Patients with OA were compared with a group of patients who had hand symptoms from other causes, such as rheumatoid arthritis and the spondylarthropathies. Variables from the medical history, physical examination, laboratory tests, and radiographs were analyzed. All patients had pain, aching, or stiffness in the hands. Patients were classified as having clinical OA if on examination there was hard tissue enlargement involving at least 2 of 10 selected joints, swelling of fewer than 3 metacarpophalangeal joints, and hard tissue enlargement of at least 2 distal interphalangeal (DIP) joints. If the patient had fewer than 2 enlarged DIP joints, then deformity of at least 1 of the 10 selected joints was necessary in order to classify the symptoms as being due to OA. The 10 selected joints were the second and third DIP, the second and third proximal interphalangeal, and the trapeziometacarpal (base of the thumb) joints of both hands. Criteria derived using the {"}classification tree{"} method were 92{\%} sensitive and 98{\%} specific. The {"}traditional format{"} classification method required that at least 3 of these 4 criteria be present to classify a patient as having OA of the hand. The latter sensitivity was 94{\%} and the specificity was 87{\%}. Radiography was of less value than clinical examination in the classification of symptomatic OA of the hands.",
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