THE AMERICAN-COLLEGE-OF-RHEUMATOLOGY CRITERIA FOR THE CLASSIFICATION AND REPORTING OF OSTEOARTHRITIS OF THE HAND
THE AMERICAN-COLLEGE-OF-RHEUMATOLOGY CRITERIA FOR THE CLASSIFICATION AND REPORTING OF OSTEOARTHRITIS OF THE HAND
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DOI：
10.1002/art.1780331101
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发表时间：
1990-11-01
影响因子：
--
通讯作者：
WOLFE, F
中科院分区：
文献类型：
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作者：
ALTMAN, R;ALARCON, G;WOLFE, F
根据多中心研究收集的数据，制定了手部症状性特发性（原发性）骨关节炎（OA）的临床分类标准。将OA患者与一组因其他原因（如类风湿性关节炎和脊柱关节病）而出现手部症状的患者进行比较。从病史、体格检查、实验室检查和X光片中分析变量。所有患者都有手部疼痛或僵硬。如果在检查时，10个选定关节中至少有2个出现硬组织肿大，3个掌指关节肿胀，至少2个远端指间关节（DIP）硬组织肿大，则将患者归类为临床OA。如果患者的扩大DIP关节少于2个，则必须在所选的10个关节中至少有1个出现畸形，才能将症状归类为OA引起的。选择的10个关节是双手的第二和第三DIP、第二和第三DIP、第二和第三近端指间关节以及拇指掌侧（拇指基部）关节。使用“分类树”方法得出的标准为92%的敏感性和98%的特异性。“传统格式”分类方法要求这4个标准中至少有3个存在，以将患者分类为患有手部OA。后者的敏感性为94%，特异性为87%。在手部症状性骨关节炎的分类中，放射学检查的价值低于临床检查。
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 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.