The Nor-Hand Study
The Nor-Hand Study
The Nor-Hand study is a hospital-based observational study including 300 patients with
 evidence of hand OA by ultrasound and/or clinical examination. The baseline examination
 (2016-17) consists of functional tests and joint assessment of the hands, medical assessment,
 pain sensitization tests, ultrasound (hands, acromioclavicular joint, hips, knees and feet),
 computer tomography (CT) and Magnetic Resonance Imaging (MRI) of the dominant hand,
 conventional radiographs of the hands and feet, fluorescence optical imaging of the hands,
 collection of blood and urine samples as well as self-reported demographic factors and
 OA-related questionnaires. Two follow-up examinations are planned after 3 (2019-20) and 8
 years (2024-25), respectively. Cross-sectional analyses will be used to investigate
 agreements and associations between different relevant measures at the baseline examination,
 whereas the longitudinal data will be used for evaluation of predictors for clinical outcomes
 and disease progression.
Inclusion Criteria:

 -  Age between 40-70 years at screening

 -  Proven hand OA by clinical examination and/or ultrasound

 1. Clinical examination criteria: Heberden/Bouchards nodes and/or bony enlargement,
 squaring and/or deformity of the thumb base and no clinical signs of inflammatory
 arthritis (e.g. soft tissue swelling of two or less metacarpophalangeal (MCP)
 joints, and no soft tissue swelling of the wrist).

 2. Ultrasound criteria: Osteophytes in the interphalangeal joints and/or the thumb
 base, and no signs of inflammatory arthritis (e.g. synovitis with power Doppler
 activity in two or less MCP joints and no synovitis with power Doppler activity
 in the wrist).

 -  Capable of understanding and signing an informed consent form

 -  Provided a written informed consent to participate in the study

 Exclusion Criteria:

 -  Diagnosis of inflammatory arthritic disease, e.g. seropositive or seronegative
 rheumatoid arthritis, psoriatic arthritis, reactive arthritis, spondyloarthritis or
 arthritis related to connective tissue disorders

 -  Diagnosis of psoriasis

 -  Erythrocyte sedimentation rate (ESR) > 40 mm/hour and/or C-reactive protein (CRP) >20
 mg/L, without a known ongoing infection

 -  Anti Cyclic Citrullinated Protein (anti-CCP) and/or rheumatoid factor positivity

 -  Ferritin >200 microgram/L for women and >300 microgram/L for men and s-iron/s-total
 iron binding capacity (TIBC) above 50%

 -  Major co-morbidities (e.g. severe malignancies, severe diabetes mellitus, severe
 infections, uncontrollable hypertension, severe cardiovascular disease or severe
 respiratory disease)

 -  Mental or psychiatric disorders, alcohol or drug abuse, language difficulties or other
 factors that make compliance to the study protocol difficult.