Aim: To assess the validity and the relhiability of the Hand Functional Index (First nine questions of the Keitel Function Test) in rheumatoid hand.
 

Methods: outpatients and inpatients with rheumatoid arthritis (RA) according to the ACR criteria were recruited. Interrater reliability was examined. Face, content, construct validity (convergent and divergent validities9 were investigated. Factor analysis followed by varimax rotation was perormed. Spearman's correlation coefficients (rho) between 2 quantitative veriables were examined. The level of significance was p<0.05.
 

Results: 96 patients (79 female) with mean age 51.1 8SS: 13.2) were recruited. Interrater reliability of HFI is 0.86. HFI has good correlation with VAS of functional limitation (rho: 0.76), moderate correlation with functional disability scales (DHI, RFG, rho is respectively 0.58, 0.57) and fair correlation with VAS of handicap (rho: 0,44). According to its good and modarate relation with other functional scales we may say that HFI has a convergent validity. HFI has little or no relation with disease activity parameters such as morning stiffness (rho: 0,19), VAS of elbow-shoulder-neck (rho: 0.27), VAS of hands (rho: 0.25), tenderness (rho: 0.22), swelling (rho: 0.19), HFI has also fair relation with some demographic date (age and disease duration; rho is respectively 0.37 and 0.39). According to its fair and no relation with non-functional data, we may say that HFI has a divergent validity. Four main factor were found by factor analysis: i) wrist motions, ii) right hand's 2nd, 3rd, 4th, and 5 th fingers flexion, iii) left hand's 2nd, 3rd, 4th and 5th fingers flexion, iv) opposition of thumbs.
 

Conclusion: Hand functional index has a good validation results and high interrater reliability in patients with rheumatoid arthritis. We may use HFI to assess the functional impairment of the rheumatoid hand in clinical practice.