2023 EULAR classification criteria for hand osteoarthritis
Annals of the Rheumatic Diseases, vol. 83, pp. 1428–1435
Abstract
OBJECTIVES: The objective of this study is to develop classification criteria for overall hand osteoarthritis (OA), interphalangeal OA and thumb base OA based on self-reported data and radiographic features. METHODS: The classification criteria sets were developed in three phases. In phase 1, we identified criteria that discriminated hand OA from controls. In phase 2, we used a consensus-based decision analysis approach to derive a clinician-based evaluation of the relative importance of the criteria. In phase 3, we refined the scoring system, determined the cut-offs for disease classification and compared the sensitivity and specificity of the European Alliance of Associations for Rheumatology (EULAR) criteria with the 1990 American College of Rheumatology (ACR) criteria. RESULTS: In persons with hand symptoms and no other disease (including psoriasis) or acute injury that can explain the hand symptoms (mandatory criteria), hand OA can be classified based on age, duration of morning stiffness, number of joints with osteophytes and joint space narrowing, and concordance between symptoms and radiographic findings. Using a sum of scores based on each diagnostic element, overall hand OA can be classified if a person achieves 9 or more points on a 0-15 scale. The cut-off for interphalangeal OA and thumb base OA is 8 points. While the EULAR criteria demonstrated better sensitivity than the ACR criteria in the phase 1 data set, the performance of the two criteria sets was similar in two external cohorts. CONCLUSIONS: International experts developed the EULAR criteria to classify overall hand OA, interphalangeal OA and thumb base OA in clinical studies using a rigorous methodology.
Authors 31
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Ida Kristin Haugen corresponding
Affiliation as printed
Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway ida.haugen@diakonsyk.no
Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
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Affiliation as printed
Rheumatology Section, Boston University School of Medicine, Boston, Massachusetts, USA
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Affiliation as printed
Academic Rheumatology, University of Nottingham, Nottingham, UK
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Affiliation as printed
Department of Rheumatology, Sorbonne Universite, Paris, Île-de-France, France
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Affiliation as printed
Department of Family Practice, Erasmus MC, Rotterdam, Zuid-Holland, The Netherlands
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Affiliation as printed
Primary Care Centre Versus Arthritis, Keele University, Keele, Staffordshire, UK
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Affiliation as printed
Primary Care Centre Versus Arthritis, Keele University, Keele, Staffordshire, UK
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Affiliation as printed
Clinical Epidemiology Unit, Orthopaedics, Lund University, Lund, Sweden
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Affiliation as printed
Division of Medical Services, Diakonhjemmet Hospital, Oslo, Norway
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Instituto de Investigación Sanitaria Fundación Jiménez Díaz
Affiliation as printed
Department of Rheumatology, Instituto de Investigación Sanitaria de la Fundación Jiménez Díaz, Madrid, Spain
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Queen Elizabeth Hospital · The University of Adelaide
Affiliation as printed
Rheumatology Unit, The Queen Elizabeth Hospital, The University of Adelaide, Adelaide, South Australia, Australia
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Affiliation as printed
Department of Medicine, Division of Rheumatology, Cedars-Sinai Medical Center, Los Angeles, California, USA
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Affiliation as printed
University of Iceland, Reykjavik, Iceland
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Central Finland Health Care District
Affiliation as printed
Department of Surgery, Central Finland Central Hospital, Jyvaskyla, Finland
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Affiliation as printed
Department of Rheumatology and Immunology, Singapore General Hospital, Singapore
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Affiliation as printed
Department of Rheumatology, Hospital Saint-Antoine, Paris, Île-de-France, France
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Affiliation as printed
Primary Care Centre Versus Arthritis, Keele University, Keele, Staffordshire, UK
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Affiliation as printed
Primary Care Centre Versus Arthritis, Keele University, Keele, Staffordshire, UK
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Affiliation as printed
Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
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Affiliation as printed
Rheumatology Unit, University of Padua, Padova, Veneto, Italy
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Ludwig Boltzmann Gesellschaft · Medical University of Vienna
Affiliation as printed
Center for Medical Data Science, Institute for Outcomes Research, Medical University of Vienna, Wien, Austria
Ludwig Boltzmann Gesellschaft, Wien, Austria
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Amsterdam UMC Location University of Amsterdam · Amsterdam University Medical Centers
Affiliation as printed
Department of Plastic, Reconstructive and Hand Surgery, Amsterdam, Amsterdam UMC Locatie AMC, Amsterdam, North Holland, The Netherlands
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Ludwig Boltzmann Gesellschaft · Medical University of Vienna
Affiliation as printed
Center for Medical Data Science, Institute for Outcomes Research, Medical University of Vienna, Wien, Austria
Ludwig Boltzmann Gesellschaft, Wien, Austria
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Affiliation as printed
Department of Rheumatology, University of Debrecen, Debrecen, Hajdú-Bihar, Hungary
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Leiden University Medical Center
Affiliation as printed
Department of Rheumatology, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands
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Leiden University Medical Center
Affiliation as printed
Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, Amsterdam, Noord-Holland, The Netherlands
Department of Rheumatology, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands
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Leiden University Medical Center
Affiliation as printed
Rheumatology, LUMC, Leiden, Zuid Holland, The Netherlands
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Affiliation as printed
Rheumatology, Ghent University, Gent, Belgium
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Affiliation as printed
Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
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Leiden University Medical Center
Affiliation as printed
Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
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M. Kloppenburg Aachen Department of Clinical Epidemiology Department of Rheumatology, Leiden University Medical Center
Leiden University Medical Center
Affiliation as printed
Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands
Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
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