Thumb base involvement in symptomatic hand osteoarthritis is associated with more pain and functional disability
Thumb base involvement in symptomatic hand osteoarthritis is associated with more pain and functional disability
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DOI：
10.1136/ard.2009.104562
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发表时间：
2010-03-01
影响因子：
27.4
通讯作者：
Kloppenburg, Margreet
中科院分区：
文献类型：
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作者：
Bijsterbosch, Jessica;Visser, Willemien;Kloppenburg, Margreet
目的探讨症状性手骨关节炎（OA）不同亚群对疼痛和残疾的影响。方法308例手部骨性关节炎患者中，分为仅伴有腕掌关节（CMCJ）症状组（I组，n = 20）、仅伴有指间关节（ipj）症状组（II组，n = 138）和两处均有症状组（III组，n = 150）。用AUSCAN评估手疼痛和功能，使用线性混合模型比较各组之间的差异。放射性骨关节炎采用Kellgren-Lawrence分级量表进行评估。结果I、II、III组的平均（SD） AUSCAN评分分别为23.1（11.7）、18.3（11.9）、26.4（12.5）。在调整年龄、性别、体重指数、家庭效应和有症状的手关节数量后，发现I组和II组的AUSCAN评分有显著差异，分别为7.4 （95% CI 1.8 ~ 13.0）和5.7 （95% CI 2.7 ~ 8.6）。与无CMCJ症状的患者相比，有CMCJ症状的患者的AUSCAN评分高5.8 （95% CI 3.1至8.6）。kelgren - lawrence分数在两组之间没有差异。结论在症状性手性骨关节炎中，CMCJ型骨关节炎比IPJ型骨关节炎更容易引起疼痛和残疾。因此，CMCJ型OA的治疗应得到重视，即使它与IPJ型OA相吻合。
Objective To assess the impact of different subsets of symptomatic hand osteoarthritis (OA) on pain and disability.Methods From 308 patients with hand OA a group with carpometacarpal joint (CMCJ) symptoms only (group I, n = 20) was identified as well as groups with symptoms at the interphalangeal joints (IPJs) only (group II, n = 138), and symptoms at both sites (group III, n = 150). Hand pain and function, assessed with the AUSCAN, were compared between groups using linear mixed models. Radiological OA was assessed using the Kellgren-Lawrence grading scale.Results Mean (SD) AUSCAN scores for groups I, II and III were 23.1 (11.7), 18.3 (11.9) and 26.4 (12.5), respectively. After adjustment for age, gender, body mass index, family effects and number of symptomatic hand joints, significant differences in AUSCAN scores of 7.4 (95% CI 1.8 to 13.0) between groups I and II, and 5.7 (95% CI 2.7 to 8.6) between groups II and III were found. AUSCAN scores were 5.8 (95% CI 3.1 to 8.6) higher for patients with versus patients without CMCJ symptoms. Kellgren-Lawrence scores did not differ between groups.Conclusion In symptomatic hand OA, CMCJ OA contributes more to pain and disability than IPJ OA. Hence, treatment of CMCJ OA should be emphasised, even if it coincides with IPJ OA.