What can hand sonography and nerve conduction velocity disclose regarding hand dysfunction in rheumatoid arthritis patie
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Rheumatologie Originalien Z Rheumatol https://doi.org/10.1007/s00393-020-00901-4 Accepted: 12 September 2020
E. A. Abda · M. M. Hassanien · E. Abdelrazek · S. A. Mahran
© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2020
What can hand sonography and nerve conduction velocity disclose regarding hand dysfunction in rheumatoid arthritis patients?
Redaktion U. Müller-Ladner, Bad Nauheim U. Lange, Bad Nauheim
Introduction RA is a chronic progressive autoimmune disabling inflammatory disease that has a predilection for wrist and hand joints leading to pain, inflammation, and joint destruction. Hand disability is almost universal among RA patients and assessment of disease activity does not reflect the impact of RA on hand function. Meanwhile, there is evidence that grip strength can reflect hand disability in RA patients [1]. Therefore, adding grip strength measurement as a separate entity in RA patients’ examination may be advisable [2]. Investigating the structural and neurological changes in RA hands could help in addressing the possible causes of hand disability and consequently help in planning of treatment interventions so as to prevent or minimize hand disability and improve functional outcomes. Musculoskeletal ultrasound (MSUS) is a sensitive bedside radiation-free tool that can detect even subclinical changes in the joints. In a systematic review and metaanalysis of 21 studies, MSUS was superior to conventional radiograms for detection of bone erosion, which is an indicator of joint damage; efficacy was comparable to MRI and reproducibility was good [3]. Peripheral neuropathy had been previously reported in RA patients [4, 5]. There have been some attempts to investigate different risk factors of hand dysfunction, with variable results [6, 7].
Rheumatology and Rehabilitation Department, Assiut University, Assiut, Egypt
In this study, we aimed to explore hand dysfunction in RA patients by investigating the possible role of MSUS and nerve conduction study (NCS) in detecting factors that could affect hand dysfunction.
Patients and methods Patients One hundred adult patients diagnosed with RA according to the 2010 ACR classification criteria [8] were enrolled in this single-blind, cross-sectional observational study. These patients were randomly selected from those attending the outpatient clinic of the Rheumatology and Rehabilitation Department, Faculty of Medicine, Egypt, in the period between September 2018 and September 2019. The study has been approved by the local institutional ethics review board of the Faculty of Medicine and registered at clinical trials with identification number NCT03274570. Written informed consent was obtained from each included subject. Patients with other rheumatic diseases, a history of hand trauma or surgery, and patients with neurological involvement or diabetes mellitus were excluded from the study.
Evaluation Based on reference values for adult hand grip strength measurement by Jamar dynamometer (Fabrication Enterprises, Inc., Irvington, NY, USA) in the Bohan-
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