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2023 EULAR classification criteria for hand osteoarthritis.

Haugen, Ida K; Felson, David T; Abhishek, Abhishek; Berenbaum, Francis; Bierma-Zeinstra, Sita; Dziedzic, Krysia S; Edwards, John James; Englund, Martin; Hermann-Eriksen, Merete; Herrero-Beaumont, Gabriel; Hill, Catherine; Ishimori, Mariko L; Jonsson, Helgi; Karjalainen, Teemu; Leung, Ying Ying; Maheu, Emmanuel; Mallen, Christian D; Marshall, Michelle; Moe, Rikke H; Ramonda, Roberta; Ritschl, Valentin; Ritt, Marco Jpf; Stamm, Tanja A; Szekanecz, Zoltan; van der Giesen, Florus; van de Stadt, Lotte A; van der Meulen, Coen; Wittoek, Ruth; Greibrokk, Elsie; Laheij, Hellen; Kloppenburg, Margreet


Ida K Haugen

David T Felson

Abhishek Abhishek

Francis Berenbaum

Sita Bierma-Zeinstra

John James Edwards

Martin Englund

Merete Hermann-Eriksen

Gabriel Herrero-Beaumont

Catherine Hill

Mariko L Ishimori

Helgi Jonsson

Teemu Karjalainen

Ying Ying Leung

Emmanuel Maheu

Rikke H Moe

Roberta Ramonda

Valentin Ritschl

Marco Jpf Ritt

Tanja A Stamm

Zoltan Szekanecz

Florus van der Giesen

Lotte A van de Stadt

Coen van der Meulen

Ruth Wittoek

Elsie Greibrokk

Hellen Laheij

Margreet Kloppenburg


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. 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. 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. International experts developed the EULAR criteria to classify overall hand OA, interphalangeal OA and thumb base OA in clinical studies using a rigorous methodology. [Abstract copyright: © European Alliance of Associations for Rheumatology, EULAR 2024. Re-use permitted under CC BY-NC-ND. No commercial re-use. No derivatives. See rights and permissions. Published by BMJ on behalf of EULAR.”.]


Haugen, I. K., Felson, D. T., Abhishek, A., Berenbaum, F., Bierma-Zeinstra, S., Dziedzic, K. S., …Kloppenburg, M. (in press). 2023 EULAR classification criteria for hand osteoarthritis. Annals of the Rheumatic Diseases,

Journal Article Type Article
Acceptance Date May 3, 2024
Online Publication Date May 31, 2024
Deposit Date Jun 17, 2024
Journal Annals of the rheumatic diseases
Print ISSN 0003-4967
Electronic ISSN 1468-2060
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
Keywords Epidemiology, Osteoarthritis, Patient Reported Outcome Measures
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