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At least 739 records · Page 41Linked to original sources
PubMed1999

Degeneration of the scaphoid-trapezium joint: a useful finding to differentiate calcium pyrophosphate deposition disease from osteoarthritis.

This study aimed to determine whether osteoarthritis of the scaphoid-trapezium joint (ST osteoarthritis) is associated with calcium pyrophosphate deposition disease (CPDD) in an elderly population with or without concomitant polyarthritis of the finger joints (FIPO). An age- and gender matched case-control study was performed at a university hospital outpatient clinic. Cases and controls were identified from a clinical registry. The case ascertainment process included: (1) chart review for evidence of pyrophosphate crystals from arthrocentesis and/or cartilage calcifications and (2) blinded reading of hand X-rays by three observers for calcification of the triangular fibrocartilage and/or cartilage calcification around the spatium triangulare. Osteoarthritis was graded from 0 to 4 according to the Standard Atlas of Radiographs. The association of ST osteoarthritis with the diagnosis was examined using chi2 tests or the Wilcoxon rank sum test as appropriate. From 65 potential cases, 30 fulfilled the inclusion/exclusion criteria whereas from 185 potential controls, 81 fulfilled the inclusion/exclusion criteria. Thirty controls were matched to cases for gender and age. ST osteoarthritis was much more severe in CPDD (median: 3.0) than in patients with FIPO (median: 0.3) and was strongly associated with the diagnosis (odds ratio 13.8; CI 3.4-59.8). Definite ST osteoarthritis identified CPDD with a sensitivity of 83% and a specificity of 73% with regard to FIPO. It was concluded that the presence of ST osteoarthritis is a helpful diagnostic finding for the diagnosis of CPDD in an elderly, predominantly female population with a high prevalence of FIPO. Especially in cases without radiographic cartilage or fibrocartilage calcification of the wrist, ST osteoarthritis may point to the correct diagnosis.

Aged↗
PubMed2000

Osteoarticular disorders of renal origin: disease-related and iatrogenic.

Osteoarticular disorders significantly limit the quality of long-term survival with chronic renal failure. beta 2M amyloidosis is a complication of chronic renal failure that has been recognized mostly in patients receiving long-term haemodialysis. Patients with beta 2M amyloidosis typically present with the triad of shoulder periarthritis, carpal tunnel syndrome, and flexor tenosynovitis of the hands. Other musculoskeletal manifestations of beta 2M amyloidosis include destructive spondyloarthropathy, cervico-occipital pseudotumours, bone cysts, and pathological fractures. At present, only renal transplantation may slow or halt the progession of beta 2M amyloidosis. Crystal-induced arthropathy, most commonly caused by basic calcium phosphate crystals, is an important cause of acute joint inflammation in the patient with renal failure. The incidence of bone and joint infection is increased in patients undergoing dialysis. Haemodialysis and peritoneal dialysis are also associated with an erosive or destructive arthropathy of finger joints, which is not explained by local amyloid deposition.

Amyloidosis↗
PubMed2003

[Reconstruction of the extensor pollicis longus tendon by transposition of the extensor indicis tendon].

Rupture of the extensor pollicis longus-tendon (EPL) is a frequent complication after distal radius fractures. Other traumatic and non-traumatic reasons for this tendon lesion are known, including a theory about a disorder in the blood supply to the tendon itself. We examined 40 patients after reconstruction of the EPL-tendon in a mean follow-up time of 30 months. All patients were clinically examined and a DASH questionnaire was answered by all patients. The method to reconstruct the EPL-tendon was the transposition of the extensor indicis-tendon. After the operations the thumb was put in a splint for four weeks in a "hitch-hiker's-position". 31 ruptures of the tendon (77.5 %) were a result of trauma. In 20 of them (50 %) a distal radius fracture had occurred. Clinical examination included measurements of the movement of the thumb- and index-finger joints, the grip strength and the maximal span of the hand. Significant differences were not found. The isolated extension of the index finger was possible in all patients. But it was reduced in ten cases which represent 25 %. Our results were evaluated by the Geldmacher score to evaluate the reconstruction of the EPL-tendon. 20 % excellent, 65 % good, 12.5 % fair and 2.5 % poor results were reached. The Geldmacher score was used critically. We suggest its modification for the evaluation of thumb abduction. The DASH score reached a functional value of ten points which represents a very good result. In conclusion the extensor indicis-transposition is a safe method to reconstruct the EPL-tendon. Its substantial advantage is taking a healthy muscle as the motor, thereby avoiding the risk of using a degenerated muscle in late tendon reconstruction. A powerful extension of the index finger will be maintained by physical education. Generally, the loss of the extension of the index finger is negligible. It does not disturb the patients. But it has to be discussed with the patient before the operation.

Adolescent↗
PubMed2005

Axillary vein thrombosis as a manifestation of rapidly progressive neuropathic arthropathy of the shoulder associated with syringomyelia.

Neuropathic arthropathy is a destructive joint disease associated frequently with loss of proprioception. Syringomyelia (with or without Arnold-Chiari malformation) is characterized by slow progression over many years; the joints involved most frequently are the shoulders and elbows. Neuropathic arthropathy of the hand is rare, and clinical features are vasomotor problems, digital ulcers, thickening of the fingers, and painless subluxation of the finger joints. We report an unusual case of neuropathic arthropathy of the shoulder and hands, associated with syringomyelia without Arnold-Chiari malformation. Neuropathic arthropathy of the shoulder was rapidly progressive, and axillary vein thrombosis was the first manifestation; however, neuropathic arthropathy of the hands was unrecognized for 7 years, and painless ulceration of the fingers with spontaneous amputation of the terminal phalanx and Raynaud phenomenon were the initial manifestations. To our knowledge, this is the first report of a patient with this constellation of findings.

Adult↗
PubMed1971

Dupuytren's contracture of the fingers: a simplified approach to the surgical treatment.

Hematoma formation, delay in healing, pain, stiffened finger joints are complications that sometimes follow classical surgical approaches to Dupuytren's contracture. A new surgical approach to the disease that can correct the contractures without the attendant morbidity is urgently needed. By treating Dupuytren's as any other scar contracture (division of the contracting soft tissue at its point of maximal tension and interposing normal free full-thickness skin) postoperative morbidity can be greatly decreased. Full return of function was achieved within 21 days following operation in 85 percent of the cases in which finger contractures were present before operation. Contracture release of 100 joints was done by this means, with loss of only one graft and without recurrence of the disease. This technique offers simple surgical control of progressive and recurrent Dupuytren's contracture of the fingers with minimal postoperative morbidity.

Aged↗
PubMed2002

[Arthrotenolysis of the proximal interphalangeal joint of the fingers. Operative technique and results].

From 1994 to1999, 24 patients were subjected to tenoarthrolysis of the PIP joint by a single surgeon for various reasons. All cases were documented by the surgeon in photographs and the achieved extent of mobility was followed up to at least one year postoperatively. All results were documented in photographs or on video films. The patients did not have conventional arthrolysis following injury of the capsular ligaments of the PIP joint (with the exception of one case), but complex injuries of bone, flexor tendons, diseases, and conditions after infections, some of which had occurred up to seven years previously. Four patients had been subjected to tenoarthrolysis twice, one had undergone tenoarthrolysis even three times. Five joints were fully ankylotic before surgery and had 0 degrees of mobility. All cases were referred from external surgeons. It was not possible to find common denominators for these cases and to include them in a regular study. The sole criterion used for assessment, which has also been used in comparable studies, was preoperative mobility and the postoperative mobility achieved after one year. Preoperative mobility in the PIP joint was on average 27.5 degrees (range, 0 - 60) and could be increased to a mean of 70 degrees (range, 0 to 120) after one year. Thus, an improvement of 42.5 degrees was achieved. As the cases were very different, this study will probably be no more than a case presentation. Nevertheless, based on a careful assessment of video films and photographs and the results achieved in individual cases, conclusions may be drawn regarding technique, surgical planning and prognosis. The author believes that although the data does not suffice to make up a valid study, they still are worthy of presentation.

Adult↗
PubMed1979

Injuries of the proximal interphalangeal joint of the fingers.

A consecutive group of ninety-three patients with ninety-six affected joints, have been reviewed retrospectively to provide information regarding the incidence and longer term effects of injuries to the proximal interphalangeal joint of the fingers. The patients have been grouped according to the severity of the injury, judged clinically and radiologically. From this review it would appear that these injuries are somewhat less common than is suggested in the literature. The severity of the trauma would seem to influence the result in that some thirty per cent with dislocation or fracture-dislocation did badly and of these forty-three per cent had open injuries. Some experimental work on fresh cadavers, to investigate the damage to the ligaments in the more common dorsal dislocation, has been included. From our findings, suggestions have been made regarding the treatment of these injuries.

Adolescent↗
PubMed1977

Comparison of technetium uptake in small joints with other indices of inflammation in rheumatoid arthritis.

The uptake of 99mTc in the small joints of the hand has been compared to various other mesures of inflammation in 22 patients with rheumatoid arthritis. The 99mTc uptake in the finger joints can reflect both disease activity at a given time and change in activity over a period of time. The place of Tc uptake amongst other measures of inflammation, from the point of view of the 'relative efficiency' of the assessment method, is rather inferior. In evaluating the effect of antiphlogistic drugs on local inflammation, techneticum uptake may, however, prove more discriminating than grip-strength or the number of painful joints, since the latter measures depend largely on the degree of destruction.

Adult↗
PubMed1990

Construction of a simple test for assessment of hand function in primary care. Theories and experimental trials for the test situation.

This paper describes a hand test consisting of three steps to test the subject's ability to grasp firmly another person's hand to hold a pencil firmly with fingers II-V with straight knuckles and maximally flexed finger joints, while the investigator pulls the pencil to hold on to a piece of paper with a rounded pinch grip between thumb and index finger while the investigator pulls the paper with a rounded pinch grip with submaximal strength. All three steps must be performed with each hand without causing pain. The test was an adequate parameter for the grip function, and at the same time could register work-load elicited pain, strength, and mobility. The test can be carried out by healthy subjects, but not by patients with rheumatoid arthritis. The test is logically constructed and has a high validity and reliability.

Adult↗
PubMed1977

[Osteodystrophic changes in the hands of female textile workers].

The incidence of arthromyalgic complaints and osteodystrophy of the right hand of a group of textile workers were sought with the aid of the method for clinical-social study, clinical observation and X-ray macromorphological investigation of the bone structure. The high epidemiology index of rheumatoarthrological diseases is preceded by the accumulation, as early as the first years of textile period, of structural changes of the bone tissue (under the wide effect of labour-production environment). Two types of macromorphological changes are indicated: the first are with a maximum of 3-5 years from the beginning of the textile occupation and correlate with certain changes in the regulatory-adaptive customs and the second are mainly hyperostotic--age accounted for and an expression of summed effect of articular wear out and chronic microtraumatism.

Adolescent↗
PubMed1998

Simultaneous dorsal dislocation of the metacarpophalangeal and carpometacarpal joints of a finger.

A case of simultaneous dorsal dislocation of the metacarpophalangeal (MP) and carpometacarpal (CMC) joints in the little finger is presented. The patient required a second surgical intervention for volar subluxation of the MP joint which occurred while wearing a dorsal splint following open reduction of the MP joint and closed reduction of the CMC joint. Two years postoperatively, the patient was asymptomatic but was left with mild stiffness of the MP joint.

Adult↗
PubMed1999

Mechanically modulated cartilage growth may regulate joint surface morphogenesis.

The development of normal joints depends on mechanical function in utero. Experimental studies have shown that the normal surface topography of diarthrodial joints fails to form in paralyzed embryos. We implemented a mathematical model for joint morphogenesis that explores the hypothesis that the stress distribution created in a functional joint may modulate the growth of the cartilage anlagen and lead to the development of congruent articular surfaces. We simulated the morphogenesis of a human finger joint (proximal interphalangeal joint) between days 55 and 70 of fetal life. A baseline biological growth rate was defined to account for the intrinsic biological influences on the growth of the articulating ends of the anlagen. We assumed this rate to be proportional to the chondrocyte density in the growing tissue. Cyclic hydrostatic stress caused by joint motion was assumed to modulate the baseline biological growth, with compression slowing it and tension accelerating it. Changes in the overall shape of the joint resulted from spatial differences in growth rates throughout the developing chondroepiphyses. When only baseline biological growth was included, the two epiphyses increased in size but retained convex incongruent joint surfaces. The inclusion of mechanobiological-based growth modulation in the chondroepiphyses led to one convex joint surface, which articulated with a locally concave surface. The articular surfaces became more congruent, and the anlagen exhibited an asymmetric sagittal profile similar to that observed in adult phalangeal bones. These results are consistent with the hypothesis that mechanobiological influences associated with normal function play an important role in the regulation of joint morphogenesis.

Biomechanical Phenomena↗