Hand osteoarthritis and bone mineral density in postmenopausal women; clinical relevance to hand function, pain and disability.

Objective: The aim of the present study was to assess phalangeal bone mineral density (BMD) in postmenopausal females with hand osteoarthritis (OA) and to correlate the measured levels with the radiographic OA grade, pain, function and disability of the hand.

Methods: The study group constituted 40 postmenopausal women with hand OA (range; 45-83 years). Socio-demographic data were collected. They underwent a comprehensive clinical examination of joint status and health outcome measure including Australian Canadian (AUSCAN) OA hand index. Hand radiographs were quantified and graded according to Kellgren and Lawrence (K-L) scoring system. Bone mineral content (BMC) and BMD of the third finger were measured using the accuDEXA (Schick, New York, NY). Twenty females matched for age and years of menopause were studied as a control group.

Results: Phalangeal BMC and BMD were significantly reduced in women with hand OA compared to controls and related to radiological erosive OA. The AUSCAN pain and function subscales were worse in proportion to the severity of hand OA. OA X-ray score was significantly associated with reduced right grip strength, pain, and function scales while, decreased BMD was related to Ritchie index and pain scale.

Conclusion: Postmenopausal women with clinical and radiological hand erosive OA are at risk of development of hand osteoporosis (OP). Phalangeal bone densitometry is an objective reproducible investigation. Poor physical function due to increased pain associated with increasing severity of radiographic hand OA leads to worse BMD results.