Prevalence of Hand Deformities and Factors that Influence it in Patients with Rheumatoid Arthritis
Keywords:
Rheumatoid arthritis, Hand deformities, risk factorsAbstract
Background and Objectives: Hand deformity is a typical feature of the RA. Therefore it is crucial to find out the prevalence of hand deformity in RA and to identify factors associated with its presence.
Methods: A group of 100 patients with RA fulfilling the 1987 revised ACR criteria, were attending routine out patient clinics and physiotherapy unit in Rizgary Teaching hospital in Erbil, between 1st Oct. 2008 to 31st June 2009, are included, Patients who had congenital anomaly, history of trauma, patients below 16 years and other rheumatologic disease had been excluded.
Results: Hand deformity was recorded in (57%) of cases .The frequency of deformities was as follow; ulnar deviation of the MCP joints (41%), palmer subluxation of the MCP joint (38%), Z deformity(13%), boutonniere deformity (27%) , swan neck deformity (35%), radial deviation of the wrist (24%) and subluxation of the wrist joint (16%). Female to male ratio was 5:1, 55% 0f patients were between 40-59 years of age. X-ray of both hand shows 60% of patients had bone erosion, RF was positive in 73% of patients, CRP was positive in 75%. Family history was positive in 30%. There was a significant correlation between development of deformities and disease duration, No. of joints involved, RF(Rheumatoid Factor) ,CRP(C-reactive protein) and ESR(Erythrocyte sedimentation rate), other factors that had been studied but had no significant correlation with development of deformities which were age, gender, occupation, residence, type of treatment.
Conclusions: Rheumatoid arthritis is a chronic rheumatologic disease that affects the hand and causes deformities, which mainly depend on the duration of disease, so early treatment and suppression of inflammation is necessary to delay or arrest the development of deformities.
Metrics
References
James R.O Dell, Rheumatoid Arthritis. Chapter 285 In:Goldman L; Ausiello D (editors). Cecil medicine, 23rd edition. Saunders Elsevier(2008). pp 2003-2014.
Akil M, Amos R.S.. Rheumatoid Arthritis. Clinical Features & Diagnosis. In Snaith, M.L. (Ed) ABC of Rheumatology. BMJ Publishing Group, London, (1996) pp 40-43.
Christopher V. Tehlirian and Joan M. Bathon,. Clinical and laboratory manifestations. Chapter 6 Klippel JH et al Eds Primer on Rheumatic diseases Springer, 13th Ed. (2008) pp. 114-121.
Peter E. Lipsky,. Rheumatoid Arthritis. In: Fauci AS; Braunwald E; Kasper DL;Hauser SL; et, al (editors). Harrisons principles of internal medicine, 16thedition. McGrawHill companies. (2005) pp.1968-1976.
Drosos A, Epidemiology of rheumatoid arthritis. Autoimmun Rev; 3 (2004) (Suppl 1): S20–S22.
Eberhardt K, Johnson PM, Rydgren L,. The occurrence and significance of hand deformities in early rheumatoid arthritis.Br J Rheumatol [online] (1991). 30 (3); 211-213. Avalable from www. rheumatology.oxfordjournals.org [Accessed on 12.7.2009]
Flatte AE,. The care of the Athritis Hand (5 ed). Saint lois .Quality Medical Publishing (1995).
Hastings DE, Evans JA..Rheumatoid wrist deformities and their relation to ulna drift. J Bone Joint Surgery[Am] (1975). 57(7): 930-934.
Peter E. Lipsky,. Rheumatoid arthritis. In:Fauci AS;Braunwald E;Kasper DL; Hauser SL; et, al (editors). Harrisons principles of internal medicine, 16thedition. McGrawHill companies(2005). pp.1968-1976.
Madenci E and Gursoy S,. Hand deformity in rheumatoid arthritis and its impact on the quality of life. The Pain Clinic(2003) [online].15(3), pp. 255-259. Available from www.ingentaconnect.com [Accessed on 13/7/2009]
Laine VA ,Sairanen E ,Vainio K,. Finger deformities caused by rheumatoid arthritis .J Bone Joint Surg(1957) [Am].39 :527-33.
Hatice Bodur , Ozlem Yilmaz , Dilek Keskin.Hand disability and related variables in patients with rheumatoid arthritis .Rheumatology International(2005).
Ilan DI and Rettig ME.Rheumatoid arthritis of the wrist. Bull Hosp Jt Dis(2003) [on line].61(3-4):179-186. Available from www.pfizer.com. [accessed on 18.7.2009]
Randall W and King MD,. Arthritis, Rheumatoid(2009) [online].(Available from: www. emedicine.medscape.com) [Accessed on 13.7.2009]
Ansar Ahmed, S Dauphinee MJ, Talal N,. Effects of short-term administration of sex hormones on normal and autoimmune mice. J Immunol(1985). 134(1):204-210.
Van Leeuwen, MA, van Rijswijk, MH, Sluiter, et, al. Individual relationship between progression of radiological damage and the acute phase response in early rheumatoid arthritis. Towards development of a decision support system. J Rheumatol(1997); 24 (1):20.
Smolen JS, van Der Heijde DM, St Clai, EW, et al,. Predictors of joint damage in patients with early rheumatoid arthritis treated with high-dose methotrexate with or without concomitant infliximab: results from the ASPIRE trial. Arthritis Rheum(2006); 54 (3):702.
Vallbracht I, Rieber J, Oppermann M et al,. Diagnostic and clinical value of anti-cyclic citrullinated peptide antibodiescompared with rheumatoid factor isotypes in rheumatoid arthritis. Ann Rheum Dis(2004) [on line]. 63:1079-1084. Available from www.questdiagnostics.com. [Accessed on 15.7.2009].
De Vries-Bouwstra J. K. , Y. P. M. Goekoop-Ruiterman , K. N. Verpoort et al,. Progression of joint damage in early rheumatoid arthritis: Association with HLA-DRB1, rheumatoid factor, and anti-citrullinated protein antibodies in relation to different treatment strategies. Arthritis & Rheumatism(2008) [on line]. 58 (5), 1293 – 1298.Available from www.interscience.wiley.com [Accessed on 8.7.2009]
van der Heijde DM, van Riel PL, van Rijswijk MH, van de Putte LB,.Influence of prognostic features on the final outcome in rheumatoid arthritis: a review article. Semin Arthritis Rheum May(1988);17(4):284-92.
Lee DM and Weinblatt ME,. Rheumatoid arthritis. Lancet(2001). 358(9285):903-911.
Downloads
Published
How to Cite
Issue
Section
License
The copyright on any article published in Zanco J Med Sci is retained by the author(s) in agreement with the Creative Commons Attribution Non-Commercial ShareAlike License (CC BY-NC-SA 4.0).
