AI Summary & Key Takeaways
AI InsightBesides, presence of hand deformities, especially MCP and wrist subluxation combined with interosseoz atrophy was considerably contributed to the disability in RA patients.
📌 3 Key Takeaways
Abstract
Aim: We aimed to find out association of Rheumatoid Factor (RF) positivity and diasease duration with different deformities. We also investigated the affect of disease activity, pain and deformities on disability in hand function in patients with Rheumatoid Arthritis (RA). Method: We designed a cross-sectional study with 44 RA patients (27 women, 17 men). We evaluated presence of deformities in both hands. Disease activity was evaluated by DAS 28, severity of pain in hands by visual analog scale(VAS), hand grip strength by hand Jamar dynamometer finger strength by pinchmeter and disability by Q-DASH and Duruöz hand scale. Results: Ratio of patients with hand deformities was 29.54%. Ulnar deviation and limitation of dorsiflextion of wrist were the most detected deformities and found statistically higher in RF positive patients. The patients having longer disease duration (>10 years) had higher ratio of some deformities compared to short disease duration (p<0.05). The patients with hand deformities had higher duration of symptoms, Q-DASH and Duruöz scores and lower hand grip strengths compared to no deformity patients (p<0.05). The patients with higher disease activity (DAS 28>5.1) had higher Q-DASH scores and lower grip strength in both hands (p<0.05). Severity of hand pain (VAS) negatively correlated with both Q-DASH and Duruöz scores (p<0.05). Multivariate analysis showed that DAS-28 score, severity of pain and metacarpophalangeal (MCP) and wrist subluxation combined with interosseous atrophy were the independent predictive factors for disability evaluated by Q-DASH and Duruöz scores. Conclusion: Disease activity and severity of pain were important predictors of functional status. Besides, presence of hand deformities, especially MCP and wrist subluxation combined with interosseoz atrophy was considerably contributed to the disability in RA patients.
Özet
Amaç: Romatoid artritli(RA) hastalarda Romatoid Faktör (RF) varlığı ve hastalık süresi ile deformiteler arasındaki ilişkiyi ve ayrıca deformitelerin, hastalık aktivitesinin ve ağrının eldeki disabilite üzerine etkisini araştırdık. Metod: Romatoid artritli 44 hasta ile kesitsel bir çalışma planladık. Hastaların her iki elinde var olan deformiteler değerlendirildi. Hastalık aktivitesi DAS 28 skoru ile, eldeki ağrı vizüel analog skala (VAS) ile, el kavrama kas gücü jamar el dinamometresi ile, parmak kavrama gücünü pinçmetre ile, disabilite Q-DASH ve Duruöz el skalaları ile değerlendirildi. Bulgular: El deformitesi olan hastaların oranı %29,54 tü. El bileği dorsifleksiyonundaki kısıtlılık (%20,7) ve ulnar deviasyon (%18,2) tüm hastalarda en sık gözlenen deformitelerdi ve RF pozitif hastalarda istatistiksel olarak anlamlı düzeyde daha fazlaydı. Hastalık süresi daha uzun olan hastalarda (>10 yıl) daha kısa olanlara göre bazı deformiteler daha fazla gözlendi (p 5,1) hastalar, daha yüksek ortalama Q-DASH skoru ve her iki elde daha düşük el kavrama gücüne sahipti (p<0,05). Elde ağrı şiddeti (VAS), hem Q-DASH hem de Duruöz el skoru ile negatif korele bulundu (p<0,05). Çoklu regresyon analizi DAS 28 skoru, el eklemlerindeki ağrı şiddeti ve tepe vadi bulgusunun Q-DASH ve Duruöz ile değerlendirilen disabiliteyi belirleyen bağımsız değişkenler olduğunu gösterdi. Sonuç: Hastalık aktivitesi ve ağrı romatoid artritte fonksiyonel durumun önemli belirleyicileridir. Bunun yanında el deformiteleri özellikle de tepe vadi bulgusunun varlığı disabiliteye önemli düzeyde katkıda bulunur.