Остеоартроз кистей рук характеризуется дегенеративными изменениями в мелких суставах кисти, приводящими к боли и функциональным ограничениям. Для ведения пациентов в данной клинической ситуации разработан структурированный протокол первой линии.
Данный протокол первой линии основан на сочетании немедикаментозных и, при необходимости, процедурных вмешательств при ОА кистей — полный протокол с оценкой доказательной базы, включая весь спектр вариантов и их клиническое обоснование, представлен ниже.
Acupuncture was conditionally recommended for patients with knee, hip, and/or hand OA in the ACR/AF guidelines despite limited evidence, given the positive effect of acupuncture for analgesia and low risk of harm.
Thermal modalities were strongly recommended for hip OA by OARSI (conditionally not recommended for knee and polyarticular OA) and conditionally recommended by ACR/AF for knee, hip, and/or hand OA.
Cognitive behavioral therapy (CBT) was conditionally recommended for patients with knee, hip, and/or hand OA by ACR/AF on the basis of data regarding chronic pain management, although further study is needed to better assess the benefit of CBT in OA directly.
EULAR made a strong recommendation against IACS for hand OA though commented on its potential use in the case of "clear joint inflammation", whereas ACR provided a conditional recommendation for its use.
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