Patients with clinically diagnosed hand OA not fulfilling the ACR classification criteria are in an earlier disease phase and more often have thumb base OA.

To investigate the performance of the American College of Rheumatology (ACR) classification criteria for hand osteoarthritis. Longitudinal data up to four years from a cohort of consecutive patients with primary hand osteoarthritis diagnosed by their rheumatologist (Hostas study) were used to classify presence or absence of hand osteoarthritis according to the 1990 ACR criteria (traditional format: one major and 4 minor ACR criteria) (ACR Of 538 patients (mean age 61 years, 86.1% women) 485 (90.1%) fulfilled ACR criteria at baseline. Except for the minor criterion swelling of <3 MCP joints, all criteria differed between the groups. ACR In clinical practice the majority of patients fulfill the ACR classification criteria, but those in an earlier disease phase, with less signs of hand osteoarthritis or with primarily thumb base osteoarthritis are less likely to fulfill them. New classification criteria also including earlier disease stages and with attention for hand osteoarthritis subtypes are required.

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© 2023 The Authors.

Déclaration de conflit d'intérêts

The Hostas study is financially supported by the Dutch 10.13039/501100000142Arthritis Society, who did not have influence on the design, performance and analysis of the study, nor on the decision to submit the manuscript for publication. SvB, LAvdS, FRR report no conflicts of interest. MK reports consultancy/lecture fees outside the submitted work from 10.13039/100004319Pfizer, 10.13039/100004336Novartis, 10.13039/100011110UCB, 10.13039/100012525Galapagos, 10.13039/100007091Flexion, 10.13039/100016492Kiniksa, 10.13039/100003898Janssen, 10.13039/100006483AbbVie, 10.13039/100018266CHDR, all paid to institution. Royalties from Wolters Kluwer and Springer Verlag, paid to institution.