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At least 451 records · Page 25Linked to original sources
PubMed1998

Repetitive activity alters perfusion of proximal interphalangeal joints of the human hand.

OBJECTIVE: To examine whether competitive volleyball players show any difference in perfusion of their proximal interphalangeal (PIP) joints compared with a healthy group of subjects. Also to assess the viability of a dual wavelength laser Doppler imager (LDI) in making these measurements. SETTING: Physiology laboratory. PARTICIPANTS: Ten active volleyball players who had experienced repetitive finger joint injury and 12 age- and sex-matched normal control subjects. MAIN OUTCOME MEASURES: Using a modified LDI incorporating a near- infrared (850 nm) laser as well as a standard red (633 nm) laser, scans were performed over the dorsum of the hands of the volleyball players and the control group. RESULTS: Higher perfusion values were obtained with the 850-nm laser than with the red 633-nm laser. When referenced to adjacent skin blood flow, perfusion over PIP joints of volleyball players was found to be significantly higher than that in control subjects (p=0.00012; n=10-12). CONCLUSIONS: The higher perfusion values obtained using the 850-nm laser suggest that the longer wavelength laser is measuring perfusion in a greater volume of tissue, which could include subcutaneous structures. Volleyball players have significantly higher perfusion over the PIP joints, which is unlikely to be due to differences in skin perfusion over the two regions but is more likely to be related to hyperemia of the underlying PIP joints. The reason for increased PIP perfusion is not clear; it may represent ongoing tissue inflammation due to repeated injury, or it could be an adaptive response to the stresses placed on these joints by this type of repetitive activity. CLINICAL RELEVANCE: Near-infrared laser Doppler imaging has the potential to provide a noninvasive clinical assessment of finger joint injuries.

Adult↗
PubMed1989

Silicone lymphadenopathy with concomitant malignant lymphoma.

Six cases of axillary lymphadenopathy induced by silicone elastomer following silastic finger joint arthroplasty have been reported; 2 cases had associated malignant lymphoma. This is the 3rd reported case of malignant lymphoma with concomitant silicone lymphadenopathy discovered 8 years after insertion of silastic finger joint arthroplasty for longstanding rheumatoid arthritis. Histology revealed a partially replaced reactive lymph node with immunoblastic lymphoma. Both sides contained single and clusters of multinucleated giant cells with silastic particles, as well as formed asteroid bodies. Malignant lymphoma is associated with rheumatoid disease, but to date, silicone particles have not been linked to malignant lymphoma.

Aged↗
PubMed2005

[Aims of hand therapy in treatment of rheumatoid hand].

When dealing with rheumatoid arthritis, the main issues of hand therapy are the treatment of hand and finger joints. We emphasize mobilisation of joints, muscle strengthening, correcting deformities by low temperature splints and joint protection. Further tasks of occupational therapy are: Informing patients about adaptive devices and training their use as well as educational programs for patients with reduced mobility of the upper limb. The most common surgery on the rheumatoid hand, that need postoperative treatment by a hand therapist are complete and limited arthrodesis of the wrist, surgical reconstruction of tendons, arthroplasty and arthrodeses of and for finger joints, and so on. At the Nordwestdeutsches Rheumazentrum St. Josef-Stift Sendenhorst we have designed a standard postoperative management for treating arthroplasty with a "Silikonspacer" in the metacarpophalangeal joints.

Adult↗
PubMed2002

Chondroitin sulfate in erosive osteoarthritis of the hands.

The aim of this study was to evaluate the joint count for erosions in patients with erosive osteoarthritis (EOA) of the hands treated with 800 mg/day of orally administered chondroitin sulfate plus naproxen, compared with that of patients administered naproxen only. Twenty-four consecutive patients (22 women and two men, mean age 53.0 +/- 6) suffering from symptomatic OA and with radiographic characteristics of EOA were studied. The patients were divided into two groups of 12 patients each. The first group took naproxen 500 mg/day only. The second group was treated with chondroitin sulfate 800 mg/day orally plus naproxen 500 mg/day. Radiological hand examinations were performed at baseline and again after 12 and 24 months. In both groups, the joint count for erosions showed a general tendency to increase over time. Progression of erosions at 24 months was lower in patients treated with 800 mg/day chondroitin sulfate plus naproxen than in patients taking naproxen only (p <0.05). Chondroitin sulfate failed to stop the usual time-associated progression in the number of finger joints presenting erosions in EOA of the hands. It was, however, associated with a lower increase in the number of finger joints with erosions detected after 2 years of radiological observation.

Administration, Oral↗
PubMed2005

Idiopathic osteoarthritis and contracture: causal implications.

OBJECTIVE: To use the known association of idiopathic osteoarthritis with contracture as a means of searching for its cause. There are currently two theories concerning this association, one assuming that the contracture is a consequence of the osteoarthritis and the other that it precedes and causes the osteoarthritis. This study tested both theories. METHODS: Flexion ranges in the 12 finger joints were obtained by goniometric measurement in two samples of normal female subjects, one group with a mean age of 22 years (25 subjects) and one with a mean age of 45 years (50 subjects). The results were compared with the known regional prevalence of osteoarthritis in the finger joints of women. RESULTS: The older group showed evidence of reduced flexion range consistent with development of contracture in the extensor mechanism of the fingers. The distribution of the contracture showed a strong negative correlation with the regional prevalence of osteoarthritis. CONCLUSIONS: An early dorsal contracture develops in the fingers of normal subjects, but it is neither a consequence of nor the cause of digital osteoarthritis. The most parsimonious explanation for the association is that both contracture and idiopathic osteoarthritis are independent consequences of failure to use the full movement range. If this hypothesis is correct, the disease could be preventable.

Adult↗
PubMed2002

[Synovial membrane diagnostic assessment in rheumatoid arthritis].

Rheumatoid arthritis (RA) is the most frequent inflammatory rheumatic disease. At the beginning of the disease, where, based on today's knowledge the therapeutic possibilities are largest, the diagnostic methods do not permit a differentiated estimation of the prognosis. Conventional x-rays are mostly normal and serum markers unspecific. So far--in contrast to other diseases--only little information had been drawn from the pathomorphologic substrate "synovialis" itself to assess the prognosis. Reasons therefor were found in difficulties in obtaining synovial tissue besides surgical interventions, particularly in patients with early arthritis. By minimalizing the diagnostic instruments and improvement of the technique, synovial tissue sampling in RA has become minimally invasive and it is even possible to perform on the smallest joints, such as finger joints. Hereby, synovial analysis is open for detecting pathways of inflammation and joint destruction, which might support the advancement of new therapeutic strategies, followed by a better prognosis and outcome of RA.

Arthritis, Rheumatoid↗
PubMed1997

Anatomy of the intermetacarpal ligaments of the carpometacarpal joints of the fingers.

In this study, the structure of the retaining ligaments between the proximal metacarpal bones of the fingers was defined. Anatomic dissections were performed on 10 fresh cadavers. Four separate ligaments were found: a dorsal metacarpal ligament, a palmar metacarpal ligament, and 2 interosseous ligaments oriented in a V-shaped configuration. The V-shaped interosseous ligaments were found to be the strongest; along with the palmar and dorsal intermetacarpal ligaments, they form a very strong connection between the bases of the adjacent metacarpals.

Carpal Bones↗
PubMedDate not supplied

Effects of fingernail length on finger and hand performance.

The purpose of this study was to investigate effects of fingernail length on active range of motion (AROM) of the fingers, speed of finger manipulation, number of words typed, and grip strength. Fifteen normal women (mean age, 30 years) performed measurements under four conditions--with no attached fingernails and with fingernails extending 2, 1, and 0.5 cm beyond the tip of the finger. Analyses of variance showed that: 1) with fingernails of all extended lengths, grip strength measured on the first setting of the Jamar hand dynamometer decreased; 2) with fingernails 1 and 2 cm in length, AROM, grip strength on the second dynamometer setting, and finger manipulation decreased; and 3) with fingernails 2 cm in length, typing speed decreased (p < 0.05). Long fingernails limit flexion of the finger joints, particularly the metacarpophalangeal joints. Lack of finger flexion will limit excursion of long flexors and extensors in patients. It is recommended that patients cut their fingernails to a length of 0.5 cm to achieve optimal functional outcomes.

Activities of Daily Living↗
PubMed2000

Obesity, overweight and patterns of osteoarthritis: the Ulm Osteoarthritis Study.

The objective of this study was to assess the association between obesity and osteoarthritis (OA) of the knee, hip, and hand. OA patterns were studied in 809 patients with knee or hip joint replacement due to OA. Patients with OA were categorized as having bilateral or generalized OA according to the presence of radiographic OA in the contralateral joint or different finger joints, and as normal weight, overweight, or obese according to their body mass index (BMI). Odds ratios (OR) and 95% confidence intervals (CI) for relative weight and OA patterns were estimated with multivariable logistic regression. Eighty-five percent of participants had bilateral OA, 26% had generalized OA, and 31% were obese. Obesity (BMI >/= 30 kg/m(2); OR = 8.1; 95% CI: 2.4-28) and overweight (BMI >/= 25 kg/m(2); OR = 5.9; 95% CI: 2.0-18) were strongly associated with bilateral knee OA. No association between obesity and bilateral hip OA (OR = 0.7; 95% CI: 0.3-1.7) nor generalized OA (OR = 1.1; 95% CI: 0.6-2.1) was observed. Obesity seems to be a mechanical rather than a systemic risk factor for OA with the knee joint being especially susceptible.

Aged↗