Longitudinal validity of using digital hand photographs for assessing hand osteoarthritis progression over 7 years in community-dwelling older adults with hand pain

Marshall, Michelle; Jonsson, Helgi; Helgadottir, Gudrun P.; Nicholls, Elaine; Myers, Helen; Jansen, Victoria; van der Windt, Danielle

Abstract

Background
To determine the longitudinal construct validity of assessing hand OA progression on digital photographs over 7?years compared with progression determined from radiographs, clinical features and change in symptoms.

Methods
Participants were community-dwelling older adults (=50?years) in North Staffordshire, UK. Standardized digital hand photographs were taken at baseline and 7?years, and hand joints graded for OA severity using an established photographic atlas. Radiographic hand OA was assessed using the Kellgren and Lawrence grading system. Hand examination determined the presence of nodes, bony enlargement and deformity. Symptoms were reported in self-complete questionnaires. Radiographic and clinical progression and change in symptoms were compared to photographic progression. Differences were examined using analysis of covariance and Chi-Square tests.

Results
Of 253 individuals (61% women, mean age 63?years) the proportion with photographic progression at the joint and joint group-level was higher in individuals with radiographic or clinical progression compared to those without, although differences were not statistically significant. At the person-level, those with moderate photographic progression over 7?years had significantly higher summed radiographic and clinical scores (adjusted for baseline scores) compared to those with no or mild photographic progression. Similar findings were observed for change in symptoms, although differences were small and not statistically significant.

Conclusion
Assessing hand OA on photographs shows modest longitudinal construct validity over 7?years compared with change in radiographic and clinical hand OA at the person-level. Using photographs to assess overall long-term change in a person with hand OA may be a reasonable alternative when hand examinations and radiographs are not feasible.

Citation

Marshall, M., Jonsson, H., Helgadottir, G. P., Nicholls, E., Myers, H., Jansen, V., & van der Windt, D. (2019). Longitudinal validity of using digital hand photographs for assessing hand osteoarthritis progression over 7 years in community-dwelling older adults with hand pain. BMC Musculoskeletal Disorders, 20, Article 484. https://doi.org/10.1186/s12891-019-2829-0

• Journal Article Type: Article
• Acceptance Date: Sep 12, 2019
• Publication Date: Oct 27, 2019
• Journal: BMC Musculoskeletal Disorders
• Print ISSN: 1471-2474
• Publisher: BioMed Central
• Peer Reviewed: Peer Reviewed
• Volume: 20
• Article Number: 484
• DOI: https://doi.org/10.1186/s12891-019-2829-0
• Keywords: hand joints, osteoarthritis, photography, longitudinal studies, radiographic, outcomes, physical examination, clinical features
• Publisher URL: http://doi.org/10.1186/s12891-019-2829-0