OA- Hand OA Information

Question 1

Clinical signs of hand OA

Answer 1

Bony enlargements of affected joints- Heberden’s nodes, Bouchard’s nodes
Limited ROM
Crepitus with motion (grinding sensation)
Pain with motion
Malalignment and/or joint deformity

Question 2

Clinical classification of hand OA

Answer 2

Hand pain, aching, or stiffness and 3/4 of the following features:

Hard tissue enlargement of ≥2 of 10 selected joints (5 on each hand)
Hard tissue enlargement of ≥2 or more DIP (distal interphalangeal?) joints
Fewer than 3 swollen MCP (metacarpal) joints
Deformity of at least 1/10 selected joints

Question 3

Features of Heberden’s nodes: where do they develop?

Answer 3

DIP/lateral and medial aspects of the joint

Question 4

Features of Heberden’s nodes: how long do they take to develop?

Answer 4

They develop slowly, but they’‘re not painful

Question 5

Features of Bouchard’s nodes

Answer 5

Same as Heberden’s nodes, just develop in a different area and are less common

Question 6

Hand OA treatment: strongly recommended nonpharm care

Answer 6

Exercise, self-efficacy and self-management programs, first carpometacarpal orthosis (CMC)

Question 7

Hand OA treatment: conditionally recommended nonpharm care

Answer 7

Heat/therapeutic cooling, CBT, acupuncture, kinesiotaping, hand orthosis other than CMC, paraffin

Question 8

Hand OA treatment: strongly recommended pharm treatment

Answer 8

PO NSAIDs

Question 9

Hand OA treatment: conditionally recommended pharm care

Answer 9

Tramadol, topical NSAIDs, intra-articular steroids, APAP, duloxetine, chondroitin