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The use of the hand anatomic index to assess deformity and impaired function in systemic sclerosis

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Abstract

To determine the “hand anatomic index” (HAI—a quantitative measure of hand deformity) in systemic sclerosis (scleroderma) and to compare it with the other measures of hand deformity and functional impairment. The HAI (measure of open hand span minus closed hand span/lateral height of hand) was determined in 30 patients with scleroderma and compared with hand deformity (as assessed by two independent rheumatologists) and with the Health Assessment Questionnaire (mHAQ), hand strength and prehensile gripability data. The HAI was confirmed as a reliable measure which clearly distinguished patients with increasing hand deformity and separated patients with diffuse scleroderma (n=12) from limited scleroderma (n=18), P=0.005. The HAI correlated significantly with measures of global functional impairment (as measured by the mHAQ) r=−0.46, P=0.01, hand strength r=0.51, P=0.0001 and prehensile gripability, r=−0.37, P=0.05 but neither with disease duration r=−0.16, P=NS nor age at disease onset r=0.20, P=NS. It was estimated that the HAI accounts for ~25% of the total global disability (as measured by HAQ). Measurement of the HAI in scleroderma provides a reliable and objective measure reflecting variable degrees of hand deformity and functional impairment and might provide a valid clinical outcome measure in patients with this disabling disorder.

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Acknowledgements

We thank Mrs C. Thomas for typing the manuscript, Mr P Hakendorf for providing expert statistical assistance and the scleroderma patients for their willing cooperation.

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Authors and Affiliations

  1. University of South Australia, Daw Park, South Australia, Australia

    A.J. Roberts-Thomson

  2. Department of Orthopaedics, Repatriation General Hospital, Daw Park, South Australia, Australia

    N. Massy-Westropp

  3. Rheumatology Unit, Repatriation General Hospital, Daws Road 5041,, Daw Park, South Australia, Australia

    M.D. Smith, M.J. Ahern & P.J. Roberts-Thomson

  4. Department of Medicine, University of Otago Medical School, Dunedin, New Zealand

    J. Highton

Authors
  1. A.J. Roberts-Thomson
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  2. N. Massy-Westropp
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  3. M.D. Smith
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  4. M.J. Ahern
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  5. J. Highton
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  6. P.J. Roberts-Thomson
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Correspondence to P.J. Roberts-Thomson.

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No conflict of interest has been declared by the authors.

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Roberts-Thomson, A., Massy-Westropp, N., Smith, M. et al. The use of the hand anatomic index to assess deformity and impaired function in systemic sclerosis. Rheumatol Int 26, 439–444 (2006). https://doi.org/10.1007/s00296-005-0058-3

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  • DOI: https://doi.org/10.1007/s00296-005-0058-3

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