المؤلفون: Thurah, Annette de, Jensen, Henry, Maribo, Thomas, Jensen, Martin B, Sandbæk, Annelli, Hauge, Ellen-Margrethe, Rasmussen, Linda Aa

المصدر: Rheumatology; Feb2023, Vol. 62 Issue 2, p555-564, 10p

مصطلحات موضوعية: RHEUMATOID arthritis diagnosis, HAND radiography, FOOT radiography, RADIOGRAPHY, MEDICAL care, MEDICAL care use, PRIMARY health care, RESEARCH funding, MEDICAL practice, SECONDARY care (Medicine), LONGITUDINAL method, EARLY diagnosis

مصطلحات جغرافية: DENMARK

مستخلص: Objective To explore health-care use in the 12 months preceding a diagnosis of RA in Denmark. Methods We conducted a population-based cohort study using data from national registries. Every patient diagnosed with RA in 2014–18 was matched to 10 reference individuals without RA from the Danish background population. Health-care use was defined as contacts to general practitioners, contacts to private practicing physiotherapists, and X-rays of hands and/or feet performed in primary or secondary care. We estimated the monthly contact rates for patients and references in the 12 months preceding the diagnosis, and we compared incidence rates for health-care use in each month between the two groups while adjusting for sociodemographic characteristics and comorbidity. Results We included 7427 patients with RA and 74 270 references. Patients with RA had increasing contact rates with general practitioners and physiotherapists from 6 to 8 months before the diagnosis. Compared with references, women with RA had statistically significantly more contacts to general practitioners and physiotherapists during all 12 months. A similar contact pattern was seen in men, albeit less distinct. The number of X-rays increased slightly from 8 months before the diagnosis, with a steep increase in the last 3 months. Conclusion Increased contacts to general practitioners and physiotherapists were seen in all 12 months preceding the RA diagnosis, intensifying in the last 6 to 8 months. Imaging increased from 3 months before the diagnosis. This indicates an opportunity to expedite referral to specialist care and ensure earlier diagnosis of RA. [ABSTRACT FROM AUTHOR]

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المؤلفون: Agarwal, Pawan, Sharma, Dhananjaya

المصدر: Indian Journal of Surgery; Oct2022, Vol. 84 Issue 5, p947-953, 7p

مصطلحات موضوعية: FOOT surgery, HAND radiography, FOOT radiography, FUNCTIONAL status, GIANT cell tumors, PLASTIC surgery, RETROSPECTIVE studies, HAND surgery, BONE tumors, HAND, FOOT, PAIN management

مصطلحات جغرافية: INDIA

مستخلص: Giant cell tumour (GCT) of hand/feet is a rare tumour with locally aggressive biological behaviour. After excision of GCT of small bone, reconstruction is a major challenge. This article presents our experience of reconstruction following surgery for GCT of hand and feet. This retrospective study includes 9 patients of GCT (2 recurrent and 7 primary) of hand and feet. These patients underwent surgical treatment and reconstruction. Patients were followed up with physical examination, plain radiography and modified Kapandji scale for assessment of functional ability of hand. There were 5 female and 4 male with mean age of 25.44 years. At mean follow-up of 10.66 months, all patients were pain free with good union and stability; there was no stress fracture of the graft, non-union or recurrence. The mean modified Kapandji scale was 5.4. Overall, most of the patients had a fairly good functional limb. Campanacci's classification is helpful in planning the surgical treatment. Curettage or amputations do not require major reconstruction; formal reconstruction is needed after wide excision to preserve function and aesthetics. An algorithm for type of reconstruction needed after excision of GCT of small bones is provided. [ABSTRACT FROM AUTHOR]

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المصدر: BMJ: British Medical Journal; 5/11/2024, Vol. 385 Issue 8428, pq994-q994, 1p

مصطلحات موضوعية: FOOT radiography, MULTIPLE sclerosis treatment, HAND radiography, VOLVULUS, HYPERTENSION, FOOD additives, TERMINATION of treatment, FOREIGN bodies, UTERINE fibroids, TYPE 2 diabetes, ARTHRITIS, TRUST, MAGNETS, COLECTOMY, DISEASE risk factors, CHILDREN

المؤلفون: Klose-Jensen, Rasmus, Therkildsen, Josephine, Blavnsfeldt, Anne-Birgitte Garm, Langdahl, Bente L, Zejden, Anna, Thygesen, Jesper, Keller, Kresten Krarup, Hauge, Ellen-Margrethe

المصدر: Rheumatology; Mar2022, Vol. 61 Issue 3, p963-973, 11p

مصطلحات موضوعية: WRIST radiography, RHEUMATOID arthritis diagnosis, HAND radiography, FOOT radiography, CONFIDENCE intervals, METACARPOPHALANGEAL joint, CROSS-sectional method, RHEUMATOID arthritis, DESCRIPTIVE statistics, CHI-squared test, COMPUTED tomography, DATA analysis software, SENSITIVITY & specificity (Statistics), DATA analysis

مستخلص: Objective To investigate whether high-resolution peripheral quantitative CT (HR-pQCT) of two metacarpophalangeal (MCP) joints can more accurately classify patients as having erosive RA compared with conventional radiography (CR) of 44 joints in the hands, wrists and feet. Methods In this single-centre cross-sectional study, patients with established RA (disease duration ≥5 years) were investigated by HR-pQCT and CR. The second and third MCP joints of the dominant hand were assessed for erosions by HR-pQCT. CR of the hands, wrists and feet were scored according to the Sharp–van der Heijde (SHS) method. Results In total, 353 patients were included; 66 (18.7%) patients were classified as having non-erosive RA, and 287 (81.3%) had erosive RA by CR. The sensitivity and specificity (95% CI) of HR-pQCT for classifying patients as having erosive RA when standard CR of hands, wrists and feet was used as the reference was 89% (84, 92%) and 30% (20, 43%), respectively. Using HR-pQCT as the reference, the sensitivity and specificity of CR for classifying patients having erosive RA were 85% (80, 89%) and 38% (25, 52%), respectively. McNemar's χ² test showed no significant difference between the sensitivities of patients classified as having erosive RA by HR-pQCT or by CR (2.14, P  = 0.177). Conclusion The diagnostic accuracy of HR-pQCT scanning of only two MCP joints and CR of 44 joints suggests the two modalities were comparable for classifying patients with established RA as having erosive disease. Clinical trial registration ClinicalTrials.gov (NCT03429426). [ABSTRACT FROM AUTHOR]

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المؤلفون: Salaffi, Fausto, Carotti, Marina, Farah, Sonia, Ceccarelli, Luca, Di Carlo, Marco

المصدر: Journal of Medical Systems; Nov2021, Vol. 45 Issue 11, p1-9, 9p, 3 Charts, 3 Graphs

مصطلحات موضوعية: WRIST radiography, BIOTHERAPY, HAND radiography, FOOT radiography, THERAPEUTIC use of glucocorticoids, GRIP strength, EXERCISE tests, C-reactive protein, STATISTICS, MUSCLE contraction, SCIENTIFIC observation, ACADEMIC medical centers, IMMUNOGLOBULINS, CONFIDENCE intervals, ANTHROPOMETRY, AGE distribution, CROSS-sectional method, MULTIVARIATE analysis, FLUOROIMMUNOASSAY, DISCRIMINANT analysis, FISHER exact test, MANN Whitney U Test, SEX distribution, SYNTHETIC drugs, ANTIRHEUMATIC agents, COMPARATIVE studies, RHEUMATOID arthritis, DESCRIPTIVE statistics, RESEARCH funding, DISEASE duration, BLOOD sedimentation, CHI-squared test, QUESTIONNAIRES, BODY mass index, DATA analysis software, DATA analysis, RECEIVER operating characteristic curves, PEOPLE with disabilities, LONGITUDINAL method, COMORBIDITY, EDUCATIONAL attainment

مصطلحات جغرافية: ITALY

مستخلص: To investigate the relationship between handgrip strength (HGs) features, evaluated with an innovative cylindrical-shaped grip device, and demographic, anthropometric and clinical variables, in patients with rheumatoid arthritis (RA). Consecutive RA patients were prospectively enrolled for this cross-sectional study. For each patient were collected demographic, anthropometric, clinical data related to disease activity. HGs was assessed in terms of area under the force–time curve (AUC-FeT), peak grip force and time to reach the curve plateau. The correlations between the variables were studied with the Spearman's rho correlation coefficient. The receiver operating characteristic (ROC) curve analysis was used to test the discriminant accuracy of HGs features in identifying patients in moderate/high disease activity. A multivariate analysis was performed to estimate the contribution of covariates on the AUC-FeT. A significant correlation was found among AUC-FeT, age, Simplified Disease Activity Index (SDAI), Ultrasound-Clinical Arthritis Activity (US-CLARA) (all at p < 0.0001), and body mass index (BMI) (p = 0.0001). Any correlation was found between HGs and radiographic damage. The discriminatory power of AUC-FeT was good [area under-ROC curve = 0.810 (95% CI 0.746–0.864)]. Variables significantly associated with AUC-FeT in multivariate analysis were age (p = 0.0006), BMI (p = 0.012), gender (p = 0.004), SDAI (p = 0.047) and US-CLARA (p = 0.023). HGs is negatively influenced by demographic (gender and age), anthropometric (BMI), and disease activity variables (SDAI and US-CLARA). These findings highlight the role of HGs in RA patients' functional impairment and disability. [ABSTRACT FROM AUTHOR]

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المؤلفون: Edwards, Christopher J

المصدر: Rheumatology; Sep2023, Vol. 62 Issue 9, p2944-2945, 2p

مصطلحات موضوعية: HAND radiography, FOOT radiography, PATIENT aftercare, HEALTH outcome assessment, ANTIRHEUMATIC agents, RHEUMATOID arthritis, DECISION making, TUMOR necrosis factors, DISEASE remission, EARLY diagnosis, JOINTS (Anatomy), CHEMICAL inhibitors

مستخلص: The author discusses the article "Stricter treat-to-target in rheumatoid arthritis (RA) does not result in less radiographic progression: a longitudinal analysis in RA BIODAM," by Ramiro et al. Topics include factors to which the major advances seen in the treatment of RA have depended, patients with higher radiographic progression, and strengths and weaknesses of the study.

المؤلفون: Matteo, Andrea Di, Mankia, Kulveer, Nam, Jacqueline L, Cipolletta, Edoardo, Garcia-Montoya, Leticia, Duquenne, Laurence, Rowbotham, Emma, Emery, Paul

المصدر: Rheumatology; Jul2021, Vol. 60 Issue 7, p3156-3164, 9p

مصطلحات موضوعية: OSTEORADIOGRAPHY, HAND radiography, FOOT radiography, RHEUMATOID arthritis risk factors, MUSCULOSKELETAL system diseases, DISEASE progression, PATIENT aftercare, FOOT bones, BONES, ULTRASONIC imaging, SYNOVITIS, MUSCULOSKELETAL system, RISK assessment, RHEUMATOID arthritis, DESCRIPTIVE statistics, DISEASE prevalence, LOGISTIC regression analysis, COMPUTED tomography, SYMPTOMS

مستخلص: Objectives To investigate the prevalence, distribution and predictive value for the development of inflammatory arthritis (IA) of conventional radiography (CR) bone erosions (BE) in anti-CCP positive (CCP+) at-risk individuals with musculoskeletal (MSK) symptoms but without clinical synovitis. Methods Baseline CR of the hands and feet of 418 CCP+ at-risk individuals were analysed. The presence of US-BE was explored in the anatomical areas in which CR-BE were reported. Hands and feet CR at the time of progression were analysed in a subset of individuals who developed IA (73/123, 59.3%). Logistic regression analyses were performed to calculate the predictive value of baseline CR-BE for the development of IA in 394 CCP+ individuals with ≥1 follow-up visit. Results BE were detected in 17/418 (4.1%) CCP+ at-risk individuals (median Simple Erosions Narrowing Score-BE = 2.0, IQR: 1.0–2.0; median Sharp van der Heijde score-BE = 4.0, IQR: 3.0–8.5), most frequently in the foot joints (11/17, 64.7% individuals). A total of 123/394 (31.2%) CCP+ at-risk individuals developed IA; 7/17 (41.2%) with, and 116/377 (30.8%) without BE on CR (P  = 0.37). US-BE were found in 4/7 (57.1%) individuals with CR-BE who developed IA, but only in 1/10 (10.0%) who did not. At the time of progression, new BE were detected in 4/73 (5.5%) CCP+ individuals on repeated CR. In the regression analyses, baseline CR-BE were not predictive for the development of IA. Conclusions In CCP+ at-risk individuals with MSK symptoms, CR-detected BE are uncommon and do not predict the development of IA. [ABSTRACT FROM AUTHOR]

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المؤلفون: Mori, Yu, Izumiyama, Takuya, Kurishima, Hiroaki, Kamimura, Masayuki, Baba, Kazuyoshi, Mori, Naoko, Itoi, Eiji

المصدر: Journal of Orthopaedic Surgery & Research; 2/4/2021, Vol. 16 Issue 1, p1-11, 11p

مصطلحات موضوعية: FOOT radiography, HAND radiography, OSTEOPOROSIS prevention, ANTIRHEUMATIC agents, BONE resorption, DIPHOSPHONATES, FEMUR neck, HIP joint, JOINTS (Anatomy), LONGITUDINAL method, MONOCLONAL antibodies, PEPTIDES, RHEUMATOID arthritis, TREATMENT effectiveness, RETROSPECTIVE studies, POSTMENOPAUSE, DISEASE progression, PHARMACODYNAMICS

مصطلحات جغرافية: JAPAN

مستخلص: Introduction: This study aimed to determine the effects of denosumab treatment on the joint destruction of Japanese females with rheumatoid arthritis (RA) and anti-cyclic citrullinated peptide (CCP) antibodies. Materials and methods: This retrospective longitudinal study included 56 patients treated with denosumab and 50 patients treated with bisphosphonate. All participants were positive for anti-CCP antibodies. All patients also had a history of osteoporosis treatment with bisphosphonate, which was either continued or switched to 60 mg of subcutaneous denosumab injection every 6 months. To assess the progression of joint destruction, hand and foot radiographs were taken, and changes in modified total Sharp score (mTSS), erosion score (ERO), and joint space narrowing score (JSN) were evaluated at 12 months and 24 months. The changes in BMD of the lumbar spine and hip were also assessed at 12 months. Results: At 12 months, there were significant differences in the change of ERO (p = 0.015) and mTSS (p = 0.01). Similarly, there were significant differences in the change of ERO (p = 0.013) and mTSS (p = 0.003) at 24 months. In contrast, no significant difference was observed in the changes of JSN and clinical parameters. There were significant differences in the changes in BMD in the femoral neck (p = 0.011) and total hip (p = 0.012). Conclusion: Denosumab treatment might be effective for the inhibition of bone erosion progression in the patients with RA, and it potentially contributes to the treatment of osteoporosis and prevention of destructive arthritis in patients with switching treatment from bisphosphonate. [ABSTRACT FROM AUTHOR]

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المؤلفون: Alegria, Guillermo Carvajal, Milin, Morgane, Gandjbakhch, Frédérique, Saraux, Alain, Bailly, Florian, Jousse-Joulin, Sandrine, Schaeverbeke, Thierry, Lukas, Cédric, Foltz, Violaine, Fautrel, Bruno, Devauchelle-Pensec, Valérie

المصدر: Rheumatology; Jul2020, Vol. 59 Issue 7, p1566-1573, 8p, 1 Diagram, 1 Chart, 2 Graphs

مصطلحات موضوعية: FOOT radiography, HAND radiography, ARTHRITIS, LONGITUDINAL method, RHEUMATOID arthritis, RISK assessment, PREDICTIVE tests, INTER-observer reliability, DISEASE progression, INTRACLASS correlation

مصطلحات جغرافية: FRANCE

مستخلص: Objective Evaluating radiographic progression is a key component of the follow-up of patients with RA. Existing scores are ill-suited to everyday clinical practice. The objective here was to validate a new simplified radiographic score (SRS) for evaluating radiographic progression in patients with early arthritis. Methods Patients with arthritis of <6 months' duration were included in the large, prospective, nationwide, French ESPOIR cohort. Radiographs of the hands and feet were obtained at inclusion then 1 and 5 years later. The modified Sharp scores and SRS were determined by blinded readers. Interobserver reliability and intraobserver repeatability of each score, as well as agreement between the two scores, were assessed by computing the intraclass correlation coefficients. The rates of progression over the first year and the next 4 years were determined. Results The 506 patients with complete data for the first 5 years were included. At inclusion, the intraclass correlation coefficient between the two scores was good for erosions (0.715, P < 0.001), joint space narrowing (0.892, P < 0.001) and the total score (0.896, P < 0.001). Agreement between the two scores was also good for radiographic progression after 1 year (0.781, P < 0.001). The SRS had good positive and negative predictive values for slow and for rapid progression. SRS determination was less time consuming. Conclusion The SRS is effective for monitoring radiographic progression in early arthritis and is easier to use and less time-consuming than the Sharp score. The usefulness of the SRS in clinical practice deserves further evaluation. [ABSTRACT FROM AUTHOR]

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المؤلفون: Kupfer, Sivert, Winklhofer, Sebastian, Becker, Anton S., Distler, Oliver, Chung, Christine B., Alkadhi, Hatem, Finkenstaedt, Tim

المصدر: PLoS ONE; 7/10/2018, Vol. 13 Issue 7, p1-11, 11p

مصطلحات موضوعية: GOUT diagnosis, DUAL energy CT (Tomography), RADIOGRAPHIC contrast media, HAND radiography, FOOT radiography

مستخلص: Objective: The dual-energy CT (DECT) algorithm for urate detection is feasible only if hyperdense deposits are present. Based on our experience, around half of the performed DECT examinations show no such deposits and thus were useless for this indication. Our diagnostic accuracy study investigates whether conventional radiographs can serve as gatekeeper test prior to DECT for reliable exclusion of such radiopaque deposits. Materials and methods: In this retrospective study, 77 clinically indicated DECT examinations of the hand (n = 29), foot (n = 36) and ankle (n = 12) of 55 patients (13 female, mean age 62±15 years) with suspected gouty arthritis were included. Two blinded readers independently evaluated DECT, gray-scale CT images (reference standard) and corresponding standardized radiographs for the presence/location of dense soft tissue deposits. Results: Interreader agreement for detection of soft tissue deposits with DECT and radiographs was excellent (DECT: both readers, κ = 1; radiographs: both readers, κ = 0.94). DECT showed soft tissue deposits in 54/77 DECT (70%) scans. 30/54 scans (56%) showed deposits on the corresponding radiographs, while in 24 scans (44%) no deposits were seen on radiographs. Test performance of radiographs for soft tissue deposit detection: sensitivity 56%, specificity 100%, PPV 100%, NPV 48.9%, and accuracy 69%. Low density of the deposits was the main reasons for false-negative radiographs (19 cases, 79%), followed by superimposition of deposits by osseous structures (5 cases, 21%). Conclusion: Conventional radiographs of the hand, foot and ankle cannot serve as a gatekeeper test for reliable exclusion of radiopaque soft tissue deposits prior to DECT. [ABSTRACT FROM AUTHOR]

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