Predictors of stenosing tenosynovitis in the hand and hand-related activity limitations in patients with rheumatoid arthritis.

Abstract

OBJECTIVES:

To identify early predictors of stenosing tenosynovitis in the hand and hand-related activity limitations in patients with rheumatoid arthritis (RA).

DESIGN:

A longitudinal study of an inception cohort.

SETTING:

A large outpatient clinic.

PARTICIPANTS:

Consecutive patients who attended the Early Arthritis Clinic for at least 2 years and fulfilled the American College of Rheumatology criteria for RA at baseline and/or at the 1-year follow-up were invited to participate until 200 patients were included.

INTERVENTIONS:

Not applicable.

MAIN OUTCOME MEASURES:

Stenosing tenosynovitis, assessed by means of a standardized physical examination. Hand-related activity limitations, assessed with the Disabilities of Arm, Shoulder and Hand questionnaire (DASH). A DASH score above the upper limit of the 95% range of the normative score was defined as abnormal. Prognostic factors: demographic and disease activity-related variables, radiographic damage, the Health Assessment Questionnaire (HAQ) total score and category scores at the 2-year follow-up.

RESULTS:

The mean age ± SD of the patients was 59.7±10.7 years (75% female). The mean time ± SD between the 2-year follow-up and the assessment of the dependent variables was 3.9±2.7 years. Stenosing tenosynovitis was present in 33%. The median (interquartile range) DASH score was 26.7 (10.8-42.5); 30% were abnormal. Stenosing tenosynovitis was predicted by the HAQ subscale regarding the use of hands (HAQ-hand) at the 2-year follow-up (odds ratio [OR], 2.3; 95% confidence interval [CI], 1.2-4.2). Hand-related activity limitations were predicted by the Disease Activity Score in 28 joints (OR, 1.8; 95% CI, 1.3-2.4) and HAQ-hand (OR, 2.4; 95% CI, 1.3-5.8) at the 2-year follow-up.

CONCLUSIONS:

Stenosing tenosynovitis in patients with RA was predicted by HAQ-hand at the 2-year follow-up, and hand-related activity limitations were predicted by disease activity and HAQ-hand at the 2-year follow-up.

• Authors: Jennie Ursum, Noortje C Horsten, Agnes F Hoeksma, Ben A Dijkmans, Dirk L Knol, Dirkjan van Schaardenburg, Joost Dekker, Leo D Roorda
• Journal: Archives of physical medicine and rehabilitation (Arch Phys Med Rehabil) Vol. 92 Issue 1 Pg. 96-100 (Jan 2011) ISSN: 1532-821X [Electronic] United States
• PMID: 21187211 (Publication Type: Journal Article)
• Copyright: Copyright © 2011 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Topics

• Aged
• Arthritis, Rheumatoid (diagnostic imaging, pathology, physiopathology)
• Arthrography
• Disability Evaluation
• Female
• Foot (diagnostic imaging)
• Hand (diagnostic imaging, physiopathology)
• Health Status
• Humans
• Joints (pathology, physiopathology)
• Longitudinal Studies
• Male
• Middle Aged
• Physical Therapy Modalities
• Prognosis
• Socioeconomic Factors
• Tendon Entrapment (diagnosis, diagnostic imaging, physiopathology)