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At least 19 recordsLinked to original sources
PubMed1979

Relationship between radiographic signs in the temporomandibular joint and hand joints.

The temporomandibular joints of 64 patients and the hand joints of 62 patients with mandibular pain and/or dysfunction were exposed in oblique lateral transcranial, transmaxillary, and dorso-volar projections. The relationship between radiographic signs generally ascribed to osteoarthrosis was investigated. Indices were constructed to quantify the radiographic findings in the two joints. In the temporomandibular joint statistically significant age-independent correlations were found between flattening of the lateral part of the condyle, subcortical sclerosis of the condyle and reduced joint space. In the hand joints statistically significant age-independent correlations were found between osteophytes, subcortical sclerosis, eroded/absent cortical outlining, reduced/obliterated joint space and dislocations. No statistically significant correlation could be found between radiographic findings in the temporomandibular and hand joints. It is concluded that the radiographic signs in the temporomandibular joint of reduced joint space, subcortical sclerosis of the condyle and flattening of the lateral part of the condyle are interrelated and probably characteristic of osteoarthrosis, and that these relationships are similar to those that occur in the hand joints.

Adolescent↗
PubMed1998

Destruction and reconstruction of hand joints in rheumatoid arthritis. A 20 year followup study.

OBJECTIVE: To examine the radiographic endpoint changes and performed joint fusions and arthroplasties in hand joints in rheumatoid arthritis (RA) occurring over a 20 year period. METHODS: In 83 patients with recent (< 6 months) rheumatoid factor positive RA, radiographs were taken at 15 and 20 years from entry. The Larsen grades for 12 hand joints were evaluated, as well as the preoperative grades for reconstructed joints. Data of the performed hand joint fusions and arthroplasties were obtained. RESULTS: At 15 year followup the mean Larsen grade of wrist joints was 2.5, metacarpophalangeal (MCP) I-V 1.0-1.8, and interphalangeal I and proximal interphalangeal (PIP) II-V 0.7-0.9. At the endpoint the mean grades were: wrist joint 2.7, MCP I 1.1, MCP II 2.2, MCP III 1.9, MCP IV 1.3, MCP V 1.5, IP I and PIP II-V 0.7-1.0. Modified Larsen grade for carpometacarpal I was 1.6 and 2.0 at 15 year followup and endpoint, respectively. Reconstructive surgery was performed in 33/83 patients. The number of operations was 83, and 38 of them were wrist fusions. CONCLUSION: In this inception cohort, wrist joints had the highest destruction and the need for reconstructive surgery; the grade of destruction was lower in MCP and PIP joints, in this order. Possibilities of reconstructive surgery are discussed.

Adolescent↗
PubMed1999

Cancer risk among patients with finger and hand joint and temporo-mandibular joint prostheses in Denmark.

The use of artificial joint implants has risen greatly over the past years. However, few investigations of the cancer risk associated with implants have been performed. We investigated cancer risk in patients with finger and hand joint and temporo-mandibular (TMJ) joint implants. A nationwide cohort in Denmark of patients with finger and hand joint prostheses (n = 858) or TMJ implants (n = 389) was followed from January 1, 1977, to December 31, 1995, to evaluate any potential cancer risks subsequent to receiving these implants. Standardized incidence ratios (SIRs) for all cancers were 1.0 (95% CI = 0.8-1.2) for the finger and hand joint cohort and 1.1 (95% CI = 0.8-1.7) for the TMJ cohort. A significant risk for non-Hodgkin's lymphoma was found in the finger and hand joint cohort (SIR = 3.8, 95% CI = 1.5-7.8). When the finger and hand joint cohort was stratified by diagnosis of rheumatoid arthritis, the excess risk was seen only in the group with rheumatoid arthritis. This is consistent with past studies, which have found an association between rheumatoid arthritis and non-Hodgkin's lymphoma. Our results provide evidence that the cancer risk for patients with finger and hand joint prostheses and TMJ implants is similar to that for the general population.

Aged↗
PubMed2000

Higher grip strength increases the risk of incident radiographic osteoarthritis in proximal hand joints.

Quadriceps strength may protect against knee osteoarthritis (OA), but muscle activity is a major determinant of forces at the hand joints. Gripping objects is a common task during which high muscular forces are sustained, particularly at the proximal hand joints (metacarpophalangeal (MCP) joints and thumb base). The association between maximal grip strength and incident OA at different hand joints was examined in a longitudinal study of radiographic hand OA. Subjects with higher maximal grip strength were at increased risk for development of OA in the proximal interphalangeal (PIP) joints, MCP and thumb base joints in men; and in the MCP in women. No association was found between maximal grip strength and incident distal interphalangeal (DIP) joints OA in men or women. The conclusion is that increased grip strength, which is the major force of loading across proximal hand joints, increases the risk of OA in those joints.

Female↗
PubMedDate not supplied

Contrast enhanced Gd-DTPA magnetic resonance imaging in the evaluation of rheumatoid arthritis during a clinical trial with DMARDs. A prospective two-year follow-up study on hand joints in 31 patients.

OBJECTIVE: The aim of this prospective 24-month follow-up study was to compare clinical features with radiological and magnetic resonance imaging (MRI) findings in evaluating synovial proliferation in the hand joints of 31 patients with rheumatoid arthritis (RA). A single joint was used for the follow-up of each patient. METHODS: Thirty-one small hand joints were examined by conventional radiography and MRI before and after 24 months of treatment. MRI assessment of disease progression (volume and/or signal intensity of the synovial proliferation on T1 weighted precontrast, T1 weighted postcontrast and T2 weighted images) was compared with a clinical assessment of the chosen joints, and with a plain x-ray film evaluation (Larsen's score). RESULTS: Of 26 joints which clinically improved (14 markedly and 14 slightly) during the study, on MRI 16 showed improvement, 8 showed no change, and 2 showed deterioration. Four clinically unchanged joints appeared improved on MRI. One joint deteriorated clinically and on MRI. Overall, there was a 58% congruence between clinical and MRI findings. On x-ray 23 joints showed no change; nine of these were also unchanged on MRI, while 13 showed improvement and one deterioration. Only in 2 out of 8 joints showing deterioration on x-ray were the MRI findings in accordance. In the remaining six joints MRI showed improvement. The congruence between x-ray and MRI was therefore 36%. CONCLUSION: The long-term follow-up of rheumatoid synovial proliferation of the small joints in the hand using contrast enhanced MRI is feasible and may provide additional information regarding disease activity. Important advantages over conventional radiography methods are its ability to demonstrate qualitative differences of synovial proliferation within bone erosions, and demonstrate not only deterioration, but also the improvement of inflammatory disease.

Adult↗
PubMed1981

Handedness and hand joint changes in rheumatoid arthritis.

This study investigates the relationship of hand use to the deforming hand joint changes of rheumatoid arthritis. Measurements of metacarpophalangeal lateral mobility, loss of metacarpophalangeal hyperextension, thumb metacarpophalangeal range of motion, and lateral pinch strength were statistically compared across dominant and nondominant hands of 51 adult subjects who had definite or classical rheumatoid arthritis. Incidence of boutonniere and swan neck deformities and distal radioulna laxity was also recorded. Results of a multivariate analysis of variance of the difference scores between dominant and nondominant measures were not significant. The authors concluded that the relationship of hand use to joint destruction is not yet clearly defined and further study is needed. Implications for treatment principles of joint protection are presented.

Adult↗
PubMed1986

[Autoplastic foot-to-hand joint transplantations].

Our surgical experience in the field of total and partial foot-to-hand joint transplants has evolved over the past 9 years (1973). In the case of serious traumatic injury of finger joints of the hand, we don't suggest any surgical solution other than that of arthrodesis or arthroplasty of the damaged joint. In our experience joint transplantation is a reconstructive operation of the whole functionality of the injured finger. This operation partially restores the active function of the finger involved and gives both the patient and the surgeon the possibility of an alternative to arthrodesis, arthroplasty or painful instability of the destroyed joint, thus avoiding their characteristic disabilities. The transplantation guarantees a true stability of the joint and in the majority of cases the disappearance of pain. The technique described are the result of our experience in treating our clinical cases which consist of 20 patients treated, over more than 9 years at the Division of Hand Surgery of Traumatologic and Orthopaedic Center of Turin. The total number of transposed joints is 22, 16 of which are hemiarticular grafts. The operations have concerned 8 M.P. and 14 PIP joints of the fingers.

Adult↗
PubMed1978

The effect of long-term oestrogen treatment on the development of osteoarthrosis at the small hand joints.

The effect of long-term oestrogen treatment of at least 5 yr on the development of osteoarthrosis was studied in 48 postmenopausal women. Osteoarthrosis at the hand joints was graded according to Kellgren's criteria, using hand X-rays. Data obtained in a normal population of 155 women served as controls as well as data obtained in 24 postmenopausal women who didnot receive oestrogen replacement therapy. No significant difference in osteoarthrosis between the treated and non-treated groups was found. The development of osteoarthrosis at the hand joints seems to be independent of the hormonal status in postmenopausal women.

Aged↗
PubMed1991

Radiographic signs in the temporomandibular and hand joints in patients with psoriatic arthritis.

The temporomandibular (TMJ) and hand joints of 64 patients with psoriatic arthritis (PA) were examined radiographically with panoramic tomography and dorsovolar projection. The associations between radiographic signs in the condyle of the TMJ and finger joints were analyzed with Pearson's product-moment correlation coefficient. Twenty-six patients (41%) had radiographic signs in their TMJs. Arthritic signs were seen in 14 (22%) and degenerative signs in 12 (19%) patients. Fifty-five patients (86%) had radiographic signs in their hands; 33 patients (52%) had arthritic and 22 (34%) degenerative signs. In the TMJ statistically significant correlations were found among erosion, flattening, and cortical sclerosis and also between osteophyte and cortical sclerosis. In the finger joints erosion correlated significantly with dislocation and loss of space. Erosion in the condyle of the TMJ was the only sign that correlated with changes in the finger joints such as erosion, dislocation, and ankylosis. Erosion in the TMJ also correlated with erosion in the metacarpophalangeal joint and wrist.

Adult↗
PubMedDate not supplied

Lymphadenopathy secondary to silicone hand joint prostheses.

The occurrence of lymphadenopathies was investigated in 23 patients with diverse rheumatic conditions who had silastic prosthesis in joints of the hands, to determine whether these adenopathies were due to the presence of silicone particles. Five cases had clinically detectable lymph node enlargement and tissue samples were studied by light and scanning electron microscopy (SEM) and energy dispersive X-ray analysis (EDXA). In 3 out of the 5 cases foreign body granulomas were observed by light microscopy, SEM showing a highly irregular distribution of foreign body material with a peak for silicone by EDXA. Foreign body particle distribution closely correlated with silicone concentration. No granulomas were found in the two remaining patients with adenopathies who presented a non-specific reactive lymphadenitis. Our findings show that silicone lymphadenopathy is a more frequent complication (13%) of silastic arthroplasty than is usually recognized and therefore should be considered in the differential diagnosis of patients with lymph node enlargement who have previously received a silicone arthroplasty.

Adult↗
PubMed2003

Digital tomosynthesis of hand joints for arthritis assessment.

The two principal forms of hand arthritis, rheumatoid arthritis (RA) and osteoarthritis (OA) have large clinical and economic costs. Radiography has been shown to be a useful tool to assess the condition of the disease. A hand radiograph, however, is a two-dimensional projection of a three-dimensional object. In this report we present the results of a study that applied digital tomosynthesis to hand radiography in order to extract three-dimensional outcome measures that should be more sensitive to arthritis progression. The study was performed using simulated projection radiographs created using micro computed tomography (microCT) and a set of five dry-bone hand skeletons. These simulated projection images were then reconstructed into tomographic slices using the matrix inversion tomosynthesis (MITS) algorithm. The accuracy of the tomosynthesis reconstruction was evaluated by comparing the reconstructed images to a gold standard created using the microCT data. A parameter from image registration science, normalized mutual information, provided a quantifiable figure of merit. This study examined the effects of source displacement, number of reconstructed planes, number of acquisitions, noise added to the gray scale images, and errors in the location of a fiducial marker. We also optimized the reconstruction as a function of two variables k and alpha, that controlled the mixing of MITS with conventional shift-and-add tomosynthesis. A study using hand delineated joint margins demonstrated that MITS images provided a better measurement of average joint space width. We found good agreement between the MITS slices and the true planes. Both joint margins and trabecular structure were visible and the reconstructed slices showed additional structures not visible with the standard projection image. Using hand-delineated joint margins we compared the average joint space width of the gold standard slices to the MITS and projection images. A root-mean square deviation (RMSD), calculated for this comparison, gave RMSDproj = 0.18 mm and RMSDMITS = 0.14 mm for the projection and MITS images, respectively. We have demonstrated the potential of digital tomosynthesis for imaging of the hand to assess arthritic changes. We have also developed a methodology that can be used to optimize the technique and have studied the issues that will control the feasibility of clinical implementation.

Arthritis↗