Noortje C.A. Horsten, Jennie Ursum, Leo D. Roorda, Dirkjan van Schaardenburg, Joost Dekker, Agnes F. Hoeksma
DOI: 10.2340/16501977-0619

Objective: To determine the prevalence of hand and wrist symptoms and impairments, and the resulting activity limitations in relation to disease duration in patients with rheumatoid arthritis.
Design and patients: A cross-sectional study included 200 consecutive patients with rheumatoid arthritis in 4 categories of disease duration: 2–4, 4–6, 6–8 and ≥ 8 years. Patients were asked about the presence of various hand and wrist symptoms, and underwent a standardized physical examina­tion. To evaluate activity limitations, patients completed the Disabilities of the Arm Shoulder and Hand questionnaire and scored their limitations on a Numerical Rating Scale (0 = no to 10 = maximum limitation).
Results: Of all patients, 94% suffered from at least one symptom, and 67% had at least one impairment, mostly from the earliest stages onwards. The median standardized Disabilities of the Arm Shoulder and Hand score (interquartile range) was 26. 7 (10. 8–42. 5). The mean Numerical Rating Scale score for activity limitations was 2. 99 (standard deviation 2. 50) in the dominant hand and 2. 59 (standard deviation 2. 49) in the non-dominant hand.
Conclusion: A high prevalence of hand and wrist symptoms and impairments is often already present after 2 years of disease duration. We recommend that physicians specifically screen for these symptoms and impairments, starting 2 years after the diagnosis of rheumatoid arthritis.