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The prevalence of tenosynovitis of the interosseous tendons of the hand in patients with rheumatoid arthritis

  • Musculoskeletal
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Abstract

Aim

The aim of this study was to establish the prevalence of tenosynovitis affecting the interosseous tendons of the hand in a rheumatoid arthritis (RA) population and to assess for association with metacarpophalangeal (MCP) joint synovitis, flexor tendon tenosynovitis or ulnar drift.

Methods

Forty-four patients with RA underwent hand MRI along with 20 normal controls. Coronal 3D T1 VIBE sequences pre- and post-contrast were performed and reconstructed. The presence of interosseous tendon tenosynovitis was recorded alongside MCP joint synovitis, flexor tendon tenosynovitis and ulnar drift.

Results

Twenty-one (47.7 %) patients with RA showed interosseous tendon tenosynovitis. Fifty-two (14.8 %) interosseous tendons showed tenosynovitis amongst the RA patients. Interosseous tendon tenosynovitis was more commonly seen in association with adjacent MCP joint synovitis (p < 0.001), but nine MCP joints (5.1 %) showed adjacent interosseous tenosynovitis in the absence of joint synovitis. Interosseous tendon tenosynovitis was more frequently seen in fingers which also showed flexor tendon tenosynovitis (p < 0.001) and in patients with ulnar drift of the fingers (p = 0.01).

Conclusion

Tenosynovitis of the hand interosseous tendons was found in 47.7 % of patients with RA. In the majority of cases this was adjacent to MCP joint synovitis; however, interosseous tendon tenosynovitis was also seen in isolation.

Key Points

Tenosynovitis of the interosseous tendons of the hand occurs in rheumatoid arthritis.

Interosseous tendon tenosynovitis has a prevalence of 47.7 % in patients with RA.

Interosseous tendon tenosynovitis is related to MCP joint synovitis in the adjacent joints.

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References

  1. Brook A, Corbett M (1977) Radiographic changes in early rheumatoid disease. Ann Rheum Dis 36:71–73

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  2. Wakefield RJ et al (2007) Finger tendon disease in untreated early rheumatoid arthritis: a comparison of ultrasound and magnetic resonance imaging. Arthritis Rheum 57:1158–1164

    Article  PubMed  CAS  Google Scholar 

  3. Navalho M et al (2012) Bilateral MR imaging of the hand and wrist in early and very early inflammatory arthritis: tenosynovitis is associated with progression to rheumatoid arthritis. Radiology 264:823–833

    Article  PubMed  Google Scholar 

  4. Rakieh C et al (2013) OP0180 Risk of developing clinical synovitis in ACPA positive patients with non-specific musculoskeletal symptoms. Ann Rheum Dis 72:A114

    Article  Google Scholar 

  5. Wakefield RJ et al (2000) The value of sonography in the detection of bone erosions in patients with rheumatoid arthritis: a comparison with conventional radiography. Arthritis Rheum 43:2762–2770

    Article  PubMed  CAS  Google Scholar 

  6. Brown AK et al (2004) New approaches to imaging early inflammatory arthritis. Clin Exp Rheumatol 22:S18–S25

    PubMed  CAS  Google Scholar 

  7. Goupille P et al (2001) Magnetic resonance imaging: a valuable method for the detection of synovial inflammation in rheumatoid arthritis. J Rheumatol 28:35–40

    PubMed  CAS  Google Scholar 

  8. Eladoumikdachi F et al (2002) Anatomy of the intrinsic hand muscles revisited: part I. Interossei. Plast Reconstr Surg 110:1211–1224

    Article  PubMed  Google Scholar 

  9. Hastings DE, Evans JA (1975) Rheumatoid wrist deformities and their relation to ulnar drift. J Bone Joint Surg Am 57:930–934

    PubMed  CAS  Google Scholar 

  10. Johnsson PM, Eberhardt K (2009) Hand deformities are important signs of disease severity in patients with early rheumatoid arthritis. Rheumatology (Oxford) 48:1398–1401

    Article  Google Scholar 

  11. Aletaha D et al (2010) Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Ann Rheum Dis 69:1580–1588

    Article  PubMed  Google Scholar 

  12. Haavardsholm EA et al (2007) Introduction of a novel magnetic resonance imaging tenosynovitis score for rheumatoid arthritis: reliability in a multireader longitudinal study. Ann Rheum Dis 66:1216–1220

    Article  PubMed  PubMed Central  Google Scholar 

  13. DiBenedetto MR, Lubbers LM, Coleman CR (1991) Relationship between radial inclination angle and ulnar deviation of the fingers. J Hand Surg [Am] 16:36–39

    Article  CAS  Google Scholar 

  14. Kozin SH (1999) Arthroplasty of the hand and wrist: surgeon's perspective. J Hand Ther 12:123–132

    Article  PubMed  CAS  Google Scholar 

  15. Liss FE (2012) The interosseous muscles: the foundation of hand function. Hand Clin 28:9–12

    Article  PubMed  Google Scholar 

  16. Ikebuchi YT, Murakami, Ohtsuka A (1988) The interosseous and lumbrical muscles in the human hand with special reference to the insertions of the interosseous muscles. Acta Med Okayama 42:327–334

    PubMed  CAS  Google Scholar 

  17. Stomp W et al (2015) Aiming for a simpler early arthritis MRI protocol: can Gd contrast administration be eliminated? Eur Radiol 25:1520–1527

    Article  PubMed  Google Scholar 

  18. Tan AL et al (2005) High-resolution magnetic resonance imaging for the assessment of hand osteoarthritis. Arthritis Rheum 52:2355–2365

    Article  PubMed  Google Scholar 

  19. Jain A et al (2001) Production of cytokines, vascular endothelial growth factor, matrix metalloproteinases, and tissue inhibitor of metalloproteinases 1 by tenosynovium demonstrates its potential for tendon destruction in rheumatoid arthritis. Arthritis Rheum 44:1754–1760

    Article  PubMed  CAS  Google Scholar 

  20. Yazici Y et al (2004) Morning stiffness in patients with early rheumatoid arthritis is associated more strongly with functional disability than with joint swelling and erythrocyte sedimentation rate. J Rheumatol 31:1723–1726

    PubMed  Google Scholar 

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Acknowledgments

The scientific guarantor of this publication is Dr. Andrew Grainger. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. Dr. Grainger is receives funding from the National Institute of Health Research (NIHR), UK. No complex statistical methods were necessary for this paper. Institutional Review Board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Methodology: prospective, observational, performed at one institution.

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Correspondence to Emma L. Rowbotham.

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Rowbotham, E.L., Freeston, J.E., Emery, P. et al. The prevalence of tenosynovitis of the interosseous tendons of the hand in patients with rheumatoid arthritis. Eur Radiol 26, 444–450 (2016). https://doi.org/10.1007/s00330-015-3859-0

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  • DOI: https://doi.org/10.1007/s00330-015-3859-0

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