scholarly journals POS0126 EARLY STAGE HAND OSTEOARTHRITIS IN PATIENTS WITH THE EHLERS-DANLOS SYNDROME: AN EXPLORATIVE STUDY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 275.1-275
Author(s):  
L. Rombaut ◽  
K. De Baere ◽  
E. Debacker ◽  
L. Decavele ◽  
F. Malfait ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Clinical Features ◽  
Joint Space Narrowing ◽  
Early Stage ◽  
Hand Function ◽  
Joint Space ◽  
Joint Hypermobility ◽  
Finger Joints ◽  
Explorative Study ◽  
Soft Tissue Swelling

Background:The Ehlers-Danlos Syndromes (EDS) are a group of rare heritable connective tissue disorders caused by various defects in the biosynthesis or secretion of fibrillar collagens. The three main clinical features of EDS are joint hypermobility, skin fragility and general soft tissue fragility. 13 clinical subtypes of EDS are recognized, of which the hypermobile type (hEDS) and classical type (cEDS) are the most prevalent. It has been hypothesized that the (micro-)trauma in the joint due to typical subluxations and dislocations, make EDS patients prone to developing osteoarthritis (OA) in early stage. Conversely, it has been mentioned that joint hypermobility provides a larger joint surface area and prevents OA. Abnormal biomechanical loading has been identified as a risk factor for the development of OA in the wrist and hand. However, no studies have yet been performed in EDS patients.Objectives:The primary aim was to investigate the presence of any degenerative features for hand OA, and if this differs between cEDS and hEDS patients. The second aim was to evaluate hand function and pain related to OA signs in EDS patients.Methods:cEDS and hEDS patients between 35 and 50 years old were invited to participate. cEDS diagnosis was genetically confirmed and hEDS diagnosis was performed according the clinical 2017 hEDS criteria. Exclusion criteria were a body mass index ≥35, not being able to stand straight up for five minutes, suffering from an auto-immune disease or rheumatological condition, or pregnancy. Conventional X-rays of both hands were performed and scored independently by three assessors according to Kallman1. Presence of osteophytes (0-3), joint space narrowing (0-3), malalignment (>15°)(0/1), erosions (0/1), subchondral sclerosis (0/1), and subchondral cysts (0/1) were scored in all interphalangeal (distal and proximal), metacarpophalangeal and thumb base joints of both hands1. We defined early hand OA as minimally three features (≥1) were present. Several clinical assessments were made, e.g. tenderness, bony swelling and soft tissue swelling. The Michigan Hand Outcomes Questionnaire (MHOQ) and Australian/Canadian Osteoarthritis Hand Index (AUSCAN) questionnaires were completed.Results:In total, 31 patients (mean age 41 ± 5.6 years, 13 men and 18 women) diagnosed with EDS participated, of whom 19 with cEDS and with 12 hEDS. In total, 927 joints were assessed. Level of agreement of radiographic assessments was very high (>98%). Early hand OA was found in more than 40% of the EDS patients, with a significant higher frequency in cEDS patients compared to hEDS patients (58% vs. 17%) (p=0.032). Joint space narrowing was most frequently present and significantly more in the cEDS patients compared to hEDS patients (79% vs. 21%) (p=0.003). However, radiographic changes were found in only 10% of all finger joints. Of all fingers, thumb joints were most affected. Regarding the clinical features of hand OA, all patients showed deformity in one or more finger joints, most frequently at the thumb, especially the IP joint (both hyperflexion and hyperextension). Tenderness and bony swelling was present in 36% and 45% of all patients, respectively, whereas soft tissue swelling was less frequently observed (10% of all patients). Here, no significant differences were found between cEDS and hEDS patients. Moderate disability was present (mean (SD) AUSCAN= 45.47 (27.10) and MHQ = 65.97 (14.21). cEDS showed significant less hand pain (p=0.03), a better hand function (p=0.03) and less disability (p=0.026) than hEDS.Conclusion:This explorative study demonstrates that a high number of EDS patients present with minimal degenerative features of hand OA, but in a minority of joints. Patients with cEDS were significantly more affected, but showed a better function compared to hEDS. Possibly, cEDS patients are more susceptible to develop hand OA.References:[1]Altman R, Gold G. Atlas of individual radiographic features in osteoarthritis, revised. OARSI. 2007;15:A1-A56.Disclosure of Interests:None declared

Film-Screen Vs. Digital Radiography in Rheumatoid Arthritis of the Hand

1994 ◽  
Vol 35 (4) ◽  
pp. 311-318 ◽  
Author(s):  
Á. Jónsson ◽  
A. Borg ◽  
P. Hannesson ◽  
K. Herrlin ◽  
K. Jonsson ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Soft Tissue ◽  
Digital Radiography ◽  
Joint Space Narrowing ◽  
Digital Images ◽  
Roc Curves ◽  
Joint Space ◽  
Hard Copy ◽  
Significant Difference ◽  
Soft Tissue Swelling

In a prospective investigation the diagnostic accuracy of film-screen and digital radiography in rheumatoid arthritis of hands was compared. Seventy hands of 36 patients with established rheumatoid arthritis were included in the study. Each of 11 joints in every hand was evaluated regarding the following radiologic parameters: soft tissue swelling, joint space narrowing, erosions and periarticular osteopenia. The digital images were obtained with storage phosphor image plates and evaluated in 2 forms; as digital hard-copy on film and on a monitor of an interactive workstation. The digital images had a resolution of either 3.33 or 5.0 lp/mm. ROC curves were constructed and comparing the area under the curves no significant difference was found between the 3 different imaging forms in either resolution group for soft tissue swelling, joint space narrowing and erosions. The film-screen image evaluation of periarticular osteopenia was significantly better than the digital hard-copy one in the 3.33 lp/mm resolution group, but no significant difference was found in the 5.0 lp/mm group. These results support the view that currently available digital systems are capable of adequate diagnostic performance.

Rheumatoid Hand and Other Hand-deforming Rheumatic Conditions

2021 ◽  
Vol 25 (02) ◽  
pp. 232-245
Author(s):  
Iwona Sudoł-Szopińska ◽  
James Teh ◽  
Anne Cotten
Keyword(s):  
Bone Marrow Edema ◽  
Joint Space Narrowing ◽  
Soft Tissues ◽  
Connective Tissue Diseases ◽  
Joint Space ◽  
Imaging Features ◽  
Resonance Imaging ◽  
Soft Tissue Swelling ◽  
Rheumatic Conditions ◽  
Magnetic Resonance Imaging Mri

AbstractThe hand and wrist are commonly involved in rheumatic conditions, particularly rheumatoid arthritis and other systemic connective tissue diseases. With spondyloarthritis, hand and wrist involvement frequently occurs in psoriatic arthritis but generally does not occur in the remaining subtypes. The hand and wrist may also be affected in various metabolic and endocrine diseases, but these lie beyond the scope of this review.Radiographs may demonstrate the presence of joint space narrowing, bone loss, cysts and erosions, malalignments, and osteolysis. They may also show regions of soft tissue swelling or thinning, and detect calcifications. Ultrasonography and magnetic resonance imaging (MRI) enable evaluation of the soft tissues, particularly the synovium, tenosynovium, and tendons. Furthermore, erosions are better demonstrated than on radiographs. MRI allows evaluation of periarticular bone marrow edema.This article discusses typical imaging features of the hand and wrist in rheumatologic conditions including the advantages and limitations of the various methods.

scholarly journals Usefulness of Ultrasound Imaging in Detecting Psoriatic Arthritis of Fingers and Toes in Patients with Psoriasis

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Clara De simone ◽  
Giacomo Caldarola ◽  
Magda D'Agostino ◽  
Angelo Carbone ◽  
Cristina Guerriero ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Joint Space Narrowing ◽  
Joint Damage ◽  
Joint Space ◽  
New Bone Formation ◽  
Chronic Plaque Psoriasis ◽  
X Ray ◽  
Dermatology Clinic ◽  
Soft Tissue Swelling ◽  
Psa Progression

Background. Given that clinical evaluation may underestimate the joint damage and that early treatment can slow down psoriatic arthritis (PsA) progression, screening psoriasis patients with imaging tools that can depict early PsA changes would entail clear benefits.Objective. To compare the ability of X-ray and ultrasound (US) examination in detecting morphological abnormalities consistent with early PsA in patients with psoriasis, using rheumatological evaluation as the gold standard for diagnosis.Methods. Patients with chronic plaque psoriasis and no previous PsA diagnosis attending our outpatient dermatology clinic and reporting finger/toe joint and/or tendon pain underwent X-ray and US evaluation; they were subsequently referred to a rheumatologist for clinical examination and review of imaging findings.Results. Abnormal US and/or X-ray findings involving at least one finger and/or toe (joints and/or tendons) were seen in 36/52 patients: 11 had one or more X-ray abnormalities, including erosion, joint space narrowing, new bone formation, periarticular soft tissue swelling, and periarticular osteoporosis; 36 had suspicious changes on US.Conclusion. US proved valuable in detecting joint and/or tendon abnormalities in the fingers and toes of patients with suspicious changes. The dermatologist should consider US to obtain an accurate assessment of suspicious findings.

scholarly journals 395 OSTEOPHYTES AND JOINT SPACE NARROWING ARE INDEPENDENTLY ASSOCIATED WITH PAIN IN FINGER JOINTS IN HAND OSTEOARTHRITIS

2011 ◽  
Vol 19 ◽  
pp. S182-S183
Author(s):  
M. Kortekaas ◽  
W.-Y. Kwok ◽  
M. Reijnierse ◽  
T. Huizinga ◽  
M. Kloppenburg
Keyword(s):  
Joint Space Narrowing ◽  
Joint Space ◽  
Hand Osteoarthritis ◽  
Finger Joints

Osteophytes and joint space narrowing are independently associated with pain in finger joints in hand osteoarthritis

2011 ◽  
Vol 70 (10) ◽  
pp. 1835-1837 ◽  
Author(s):  
Marion C Kortekaas ◽  
Wing-Yee Kwok ◽  
Monique Reijnierse ◽  
Tom W J Huizinga ◽  
Margreet Kloppenburg
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Joint Space Narrowing ◽  
Joint Space ◽  
Hand Osteoarthritis ◽  
X Rays ◽  
Finger Joints ◽  
Hand Joints ◽  
American College Of Rheumatology ◽  
Structural Abnormalities

ObjectiveTo study the associations between structural abnormalities on ultrasound (US) or conventional x-rays (CR) and pain in hand osteoarthritis (HOA).MethodsIn 55 consecutive patients with HOA (mean age 61 years, 86% women) fulfilling the American College of Rheumatology criteria, pain in 30 separate hand joints was assessed upon palpation; osteophytes were assessed by US and CR and joint space narrowing (JSN) by CR. Associations between structural abnormalities and pain per joint were analysed using generalised estimated equations to account for patient effects and adjusted for age, sex, body mass index, US inflammatory features and other remaining structural abnormalities.ResultsIn 1649 joints, 69% and 46% had osteophytes on US and CR, respectively and 47% had JSN. Osteophytes and JSN showed independent associations with pain per joint adjusted: OR for osteophytes: 4.8 (95% CI 3.1 to 7.5) for US and 4.1 (95% CI 2.4 to 7.1) for CR; for JSN: 4.2 (95% CI 2.0 to 9.0).ConclusionsOsteophytes and JSN are independently associated with pain in individual HOA joints, taking into account patient effects.

scholarly journals Hand Full of Sausages-Forme Frustae of Severe Psoriatic Arthritis: A Case Report

2021 ◽  
Author(s):  
A Ramesh ◽  
C Vijayabhasar ◽  
Rajkumar Kannan ◽  
Samuel Jeyaraj Daniel ◽  
P Deepavarshini
Keyword(s):  
Psoriatic Arthritis ◽  
Joint Space Narrowing ◽  
Psoriasis Vulgaris ◽  
Joint Space ◽  
Initial Symptom ◽  
C Reactive Protein ◽  
X Ray ◽  
Reactive Protein ◽  
Erythrocyte Sedimentation ◽  
Soft Tissue Swelling

Dactylitis or sausage shaped digits is one of the hallmark features of psoriatic arthritis which occurs in association with psoriasis. This is a report of 50-year-old female, known case of psoriasis vulgaris, presented with complaints of red, painful and swollen digits of both hands since two weeks. She also complained of pain and restricted movements of all small joints of hands since two days. On examination, all the digits were erythematous, tender and swollen. Investigations revealed elevated Erythrocyte Sedimentation Rate (ESR) and C-Reactive Protein (CRP), negative rheumatoid factor and x-ray hands showed joint space narrowing and soft tissue swelling. Based on Classification Criteria for Psoriatic Arthritis (CASPAR) with score of 3/6, psoriatic arthritis was diagnosed. Further evaluation of other joints revealed features of sacroiliitis in x-ray pelvis. Psoriatic dactylitis involving all digits and as an initial symptom of psoriatic arthritis is rarely reported in literature. Dactylitis involving all the digits may be a forerunner of severe psoriatic arthritis.

scholarly journals A study of Radiological changes in Janu Sandhi in Amavata

2020 ◽  
Vol 5 (01) ◽  
Author(s):  
Wasu Isha Pradeep ◽  
Choudhari Vinod Mahadevrao
Keyword(s):  
Soft Tissue ◽  
Knee Joint ◽  
Bone Erosion ◽  
Joint Space ◽  
New Bone Formation ◽  
American College Of Rheumatology ◽  
Space Reduction ◽  
Soft Tissue Swelling ◽  
Progression Of Disease ◽  
Radiological Changes

Aim - To study radiological changes in Janu Sandhi due to Amavata. Objectives - 1) To study about Janu Sandhi and Knee Joint, 2) To study about Amavata and Rheumatoid Arthritis. Observation - The 7 diagnostic criteria according to American College of Rheumatology, epidemiology and genetics, radiological evaluation is one of them, for knee joint - soft tissue swelling, periarticular osteoporosis, joint space reduction, osteophytes, dislocation of joints, secondary eburnation, pseudocytes, periosteal new bone formation, bone erosion is seen. In radiological changes, soft tissue swelling, joint space reduction and osteophytes is found in 80% patients, periarticular osteoporosis is found in almost 90% patient. Conclusion - Female are more prone to radiological changes in knee joint affected by Amavata than male. Also age group of 41-50 yrs are more affected and Vata-Kapha Dehaj Prakruti people has more radiological changes. This is helpful to find out the extent of progression of disease in stages of disease and treatment of disease.

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