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At least 415 records · Page 23Linked to original sources
PubMed1988

Value of joint scintigraphy in the prediction of erosiveness in early rheumatoid arthritis.

The value of scintigraphy in predicting development of new erosions in small peripheral joints was studied by visual evaluation of scintigrams and by three computerised methods. In 13 patients with newly diagnosed rheumatoid arthritis a total of 387 joints were examined clinically, scintigraphically, and radiographically. The follow up period was 24 months. Four eroded joints in three patients were found at the onset. Of the joints which were to become eroded, 46/47 were scintigraphically active at all the check ups. Erosions were detected earlier in foot joints than in finger joints. New erosions were especially prone to appear in joints with persisting and high scintigraphic activity. On the contrary, inactive joints by repeated scanning never eroded. Scintigraphic and clinical activity and radiographic erosiveness correlated significantly with each other. The sensitivity and specificity of visual scintigraphic assessment and the relative pixel activity method proved to be superior to the region of interest methods and clinical evaluation for prediction of erosiveness.

Adult↗
PubMed2006

Degenerative and post-traumatic arthritis affecting the carpometacarpal joints of the fingers.

Symptomatic post-traumatic arthritis affecting the finger CMC joints is less common than might otherwise be expected based on the frequency of injury, especially to the fifth CMC joint. For the fifth CMC joint, the shallow concavoconvex articulation combined with the typical fracture location may provide a protective effect. Non-operative measures are typically successful, except in cases of missed fracture/dislocations and symptomatic joint instability. In these instances, re-construction emphasizes stability first, with an eye toward mobility for the ulnar column. It is common to detect a bony prominence in the region of the dorsal second and third CMC joints during examination of the hand. In most instances, the projection is asymptomatic and likely represents an os styloideum [18]. When painful and unresponsive to nonoperative treatments, this carpometacarpal boss can be excised surgically.

Carpal Joints↗
PubMed1984

Complete disruption of collateral mechanism of proximal interphalangeal joint of fingers.

The results are reported of a trial on the management of collateral mechanism disruption of the proximal interphalangeal joints of fingers. The incidence of the injury in Edinburgh, over a seven month period, averaged one case per week. Most (80%) had proximal avulsion of the main ligament. In the operated group all reached the state of painless stability at about two months. In the unoperated group none reached this stage, even at the final follow up, 64% complained of functional disability. It is concluded that operation is the treatment of choice for this injury.

Adult↗
PubMed1980

[Immobilization of the injured hand].

The so-called "functional position" of the hand for immobilization of an injured hand or finger may in many cases lead to stiffness of the finger joints by shrinkage of the joint capsule and -ligaments. This process can be minimized by immobilization of the small finger joints in a position where the most important ligament structures are under maximum tension. Basically this is the intrinsic-plus-position for the long fingers and palmar abduction and extension of the thumb. Immobilization in this so-called protective position of the hand minimizes immobilization damages of the small finger joints. The underlying basic principles of the anatomy are explained.

Casts, Surgical↗
PubMed2003

Jaccoud's arthropathy in systemic lupus erythematosus: differentiation of deforming and erosive patterns by magnetic resonance imaging.

OBJECTIVE: To evaluate alterations of the soft tissues, tendons, and bones as detected by magnetic resonance imaging (MRI) in patients with systemic lupus erythematosus (SLE)-associated arthritis of the finger joints. METHODS: Both hands of 14 patients with SLE of various activities and durations and with arthritis and/or deformities of the finger joints were examined by MRI and conventional radiography. Coronal T1-weighted spin-echo (with and without gadolinium contrast), axial T2-weighted turbo spin-echo, coronal fat-suppressed short tau inversion recovery, and 3-dimensional double-echo steady-state sequences were acquired and analyzed, and the findings were compared with those from conventional radiographs. RESULTS: MRI detected periarticular capsular swelling in all 14 patients, joint effusion in 7, edematous tenosynovitis in 6, proliferative tenosynovitis (flexor and/or extensor tendons) in 4, and intraarticular signs of synovial membrane hypertrophy in 10 patients, 9 of whom showed enhancement after administration of contrast medium. Bony erosions were identified in 8 patients by MRI; conventional radiography missed these erosions in 2 of the 8 patients. Four of the 14 patients were designated as Jaccoud's arthropathy index-positive, and all 4 showed severe edematous tenosynovitis and capsular swelling, but no signs of bony erosions despite longstanding disease (mean 21.5 years). Four of the 10 patients with mild deformity exhibited prominent soft tissue pathology, with minimal destruction of bone; the other 6 patients had bony alterations that resembled rheumatoid arthritis. CONCLUSION: In SLE patients with arthritis of the finger joints, MRI detects characteristic signs of soft tissue pathology (e.g., capsular swelling, edematous and proliferative tenosynovitis, synovial hypertrophy) and bony alterations (e.g., erosions, some of which are missed by conventional radiography). MRI thus helps to distinguish different types of lupus arthritis/Jaccoud's arthropathy, which allows more differentiated treatment strategies and monitoring.

Adult↗
PubMedDate not supplied

[The pincer-nail syndrome--a rare differential diagnosis of finger end joint-/nail involvement].

A 55-year-old patient who clinically presented with a Heberden arthrosis and gryphosis of the second and fourth finger nails of the left hand was admitted to our outpatient department under the tentative diagnosis of psoriatic arthritis. Nature of nail damage and combination of clinical findings suggested the diagnosis of a pincer-nail syndrome. The pathogenesis of this rare disease is not yet clear. Its complete clinical picture includes gryphosis of finger and toe nails in combination with acroosteolytic shortening of the end-phalanx and destructive arthrosis of the terminal joints of toes and fingers. Since deformation of the nail, which sometimes includes inflammation of the nail bed, may cause marked pain, surgical intervention with excision of the nail and, if necessary, revision of the nail bed has to be performed in most cases.

Arthritis↗
PubMed1978

[Ambulatory treatment of extensor-tendon injury in general surgery].

Extensor tendon injuries are mostly treated by younger general surgeons. Good follow-up results in the zone 2, 3, 4 and 6 of VERDAN are observed only 6 to 17 percent (fig. 1), which may be explained by: 1. the complicated anatomy of the extensor tendon in zone 2 to 4, 2. lack of attention to handsurgical principles, 3. infections in up to 40 per cent, which appear especially in connection with extensive soft tissue damage, 4. posttraumatic arthrosis (fig. 3) caused by lesions of the finger-joints or temporary KIRSCHNER wire fixation. The highest restriction of movement is found in the finger-joint distal to the injury (fig. 2.) The degree of flexion deficit in all finger-joints always exceeds the degree of extension deficit (fig. 4). The extension deficit alone is, therefore, not a satisfactory criterion in follow-up. The use of KIRSCHNER wire fixation by the inexperienced and the adoption of conservation therapy for zones 1 and 2 cannot be recommended.

Adult↗
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↗
PubMed2002

Assessing periarticular bone mineral density in patients with early psoriatic arthritis or rheumatoid arthritis.

BACKGROUND: Periarticular osteoporosis is an early finding in the hands of patients with rheumatoid arthritis (RA), due to release of bone resorbing cytokines from the inflamed synovium. There has been disagreement as to whether periarticular bone loss occurs in psoriatic arthritis (PsA). Bone mineral density (BMD) can now be measured accurately using dual energy x ray absorptiometry (DEXA). Recently, DEXA has been used to measure periarticular BMD at predefined regions of interest (ROIs) around the joints. OBJECTIVES: Firstly, to compare periarticular BMD around the finger joints of patients with early RA or PsA. Secondly, to determine whether periarticular bone loss is related to joint inflammation and radiological erosions in RA and PsA. METHODS: Seventeen patients with RA and 15 with PsA were recruited, all with disease duration of less than five years. All finger joints were examined by one person for swelling, or tenderness, or both. Hand radiographs were scored for the presence of erosions. Periarticular BMD was measured at 10 predetermined ROIs using a Hologic QDA-4500A fan-beam densitometer. RESULTS: Patients with PsA were less likely to be positive for rheumatoid factor (RF) (13% v 94%) and more likely to be men (60% v 23%) than patients with RA. There were no other clinical differences between patients with RA or PsA. Patients with RA had significantly lower BMD at each of the ROIs than those with PsA (p<0.05). However, these differences disappeared after adjusting for age and sex. Among patients with RA, those with a higher total number of swollen and/or tender hand joints had significantly lower periarticular BMD at the metocarpophalangeal (MCP) and proximal interphalangeal (PIP) joints. No such association was found for patients with PsA. CONCLUSIONS: In early disease, periarticular bone loss occurred both in patients with RA and those with PsA. Among patients with RA, periarticular osteoporosis was related to measures of joint inflammation. There was no association between joint inflammation and periarticular bone loss in patients with PsA, which lends support to the hypothesis that the primary site of inflammation in PsA is extrasynovial.

Absorptiometry, Photon↗
PubMed2000

The use of the motion analysis system for evaluation of loss of movement in the finger.

We have used the motion analysis system to measure loss of finger movement after injury. The motion analysis system can provide information about the dynamic angular changes of each finger joint and the fingertip motion area for the injured finger. The latter can be used to calculate the percentage of fingertip motion area preserved. A stiff finger may show limited fingertip motion area with the finger joints tending to flex and extend together.

Adult↗
PubMed2005

The scar band rotation flap.

This study presents cases in which postburn scar contractures of finger joints and interdigital spaces have been reconstructed using a scar band rotation flap. The scar band rotation flap is a subcutaneous pedicled skin island flap consisting of a contracture-causing scar band, the graft surface and normal skin. After flap rotation, the normal skin in the flap divides the scar band, thus releasing the scar contracture. In the past 10 years, we have used this reconstruction method to treat seven patients (three males and four females) ranging in age from 4 to 72 years. In all patients, the cause of the scar contractures was marginal scarring of a life-saving skin graft that was used to treat extensive burns. We reconstructed four finger joints and eight interdigital space contractures and obtained favorable results with no flap loss. We have found this method to be useful for the reconstruction of small scar contractures in locations such as finger joints and interdigital spaces after skin grafting to treat extensive burns.

Adult↗
PubMed1984

Irreducible dorsal dislocation of the distal interphalangeal joint of the finger.

Distal interphalangeal joint dislocations of the fingers are uncommon but easily reducible. Irreducible dislocations are quite rare and treatment of such a case is being reported here. Causes of irreducibility have been found to be: volar plate interposition, protrusion of the middle phalanx through the joint capsule, and flexor tendon displacement over the middle phalanx. When these situations occur open reduction is indicated.

Adult↗