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At least 91 records · Page 5Linked to original sources
PubMed1999

The effect of a joint protection education programme for people with rheumatoid arthritis.

OBJECTIVE: To evaluate the effects of an education programme in improving adherence with joint protection by people with rheumatoid arthritis (RA). DESIGN: A repeated measures design. Subjects were assessed at six weeks and one week before and six and twelve weeks after education. SETTING: Rheumatology unit in a large district general hospital. SUBJECTS: Twenty-one people diagnosed with RA (mean age 48.95 years (SD 12.54) and disease duration of 6.43 years (SD 7.7) ). INTERVENTION: An 8-hour arthritis education programme delivered over four sessions, including two hours of joint protection education designed to be typical of current UK practice. MAIN OUTCOME MEASURES: The Joint Protection Behaviour Assessment (JPBA), an observational assessment of hand joint protection methods used during kitchen activities, to measure adherence with education. Other assessments included a joint protection knowledge questionnaire, hand joint counts, hand pain visual analogue scale, the Health Assessment Questionnaire (HAQ) and HAQ Pain scale to identify any short-term changes in hand pain, pain on activity and functional status. At the beginning and end of the study subjects were interviewed to obtain their self-report of joint protection behaviours and reasons for following or not following the advice given. RESULTS: Median JPBA scores did not improve pre- to posteducation (18.4% to 23.7%; p = 0.65) and neither did hand joint count, hand pain, HAQ and HAQ Pain scores. However, joint protection knowledge improved significantly (p = 0.01) and the majority of people believed joint protection to be a beneficial strategy. Reasons for not changing behaviour included problems recalling information; joint protection being considered inappropriate as 'hands were not that bad yet'; lack of skill; and difficulties changing habits. CONCLUSION: The joint protection education programme improved knowledge but not use of taught methods. Educational strategies being used by therapists need to be focused on enhancing adherence.

Adult↗
PubMed1999

Grip strength and the risk of developing radiographic hand osteoarthritis: results from the Framingham Study.

OBJECTIVE: In knees, quadriceps strength may protect against osteoarthritis (OA). Muscle activity is a major determinant of forces at the hand joints, and grip is a common task during which high muscle forces are sustained, especially at the proximal hand joints (metacarpophalangeal [MCP] joints and thumb base). This longitudinal study of radiographic hand OA examined the association between incident OA at different hand joints and maximal grip strength. METHODS: Four hand joint groups were studied: distal interphalangeal (DIP), proximal interphalangeal (PIP), MCP, and the base of the thumb (carpometacarpal and scaphotrapezial combined). Subjects were members of the Framingham OA Study who had a baseline radiograph in 1967-1969 and a followup radiograph in 1992-1993 (mean followup 24 years) and had no prevalent radiographic OA in any hand joint at baseline. Incident disease was defined as development of OA defined as a modified Kellgren/Lawrence grade of > or =2. Grip strength was measured in kilograms by dynamometer in 1958-1961 and again in 1960-1963, and the 2 measures were averaged and divided into sex-specific tertiles. Joint-based analysis was performed by adjusting for age, physical activity, and occupational category using the lowest grip strength tertile as the referent. RESULTS: Baseline and followup radiographs were obtained from 746 subjects. Of these, 453 subjects with no prevalent OA at baseline were eligible for analysis. In men, higher maximal grip strength was associated with an increased risk of OA in the PIP (highest tertile odds ratio [OR] 2.8 compared with lowest tertile, 95% confidence interval [95% CI] 1.2-6.7), MCP (highest tertile OR 2.9, 95% CI 1.1-7.4), and thumb base joints (highest tertile OR 2.8, 95% CI 1.1-7.4). In women, there was increased risk of OA in the MCP joints (highest tertile OR 2.7, 95% CI 1.1-6.4). CONCLUSION: Men with high maximal grip strength are at increased risk for the development of OA in the PIP, MCP, and thumb base joints, and women, in the MCP joints. No association was found between maximal grip strength and incident OA in the DIP joints of men or women.

Female↗
PubMed1988

Long-term follow-up of free vascularized joint transfers to the hand in children.

Toe-to-hand vascularized joint transfers in four children were reviewed 6 to 8 years after operation (average, 6.6 years). Two children had vascularized metatarsophalangeal (MTP) joints. Both children have near normal active range of motion. The transferred epiphyses have provided a major contribution to digital growth. The other two children had second toe proximal interphalangeal (PIP) joints transferred to damaged hand joints. Active PIP joint extension has been disappointing, and the overall growth contribution of the transferred epiphysis has been small. We conclude that MTP to metacarpophalangeal vascularized joint transfer can provide painless, functional, stable motion, with near normal growth potential, and the usefulness of toe PIP to hand PIP joint transfer is limited by the inability to achieve good active extension and limited growth potential.

Child↗
PubMedDate not supplied

Evaluation of an instrumented glove for hand-movement acquisition.

Quantitative assessment of digit range of motion (ROM) is often needed for monitoring effectiveness of rehabilitative treatments and assessing patients' functional impairment. The objective of this research was to investigate the feasibility of using the Humanware Humanglove, a 20-position sensors glove, to measure fingers' ROM, with particular regard to measurement repeatability. With this aim, we performed a series of tests on six normal subjects. Data analysis was based on statistical parameters and on the intraclass correlation coefficient (ICC). Sources of errors that could affect measurement repeatability were also analyzed. The results demonstrate that, in principle, the glove could be used as goniometric device. The main advantage yielded by its use is reduction in the time needed to perform the whole measurement process, while maintaining process repeatability comparable to that achieved by traditional means of assessment. It also allows for dynamic and simultaneous recording of hand-joint movements. Future work will investigate accuracy of measurements.

Adult↗
PubMed2002

A recessive form of central core disease, transiently presenting as multi-minicore disease, is associated with a homozygous mutation in the ryanodine receptor type 1 gene.

Multi-minicore disease is an autosomal recessive congenital myopathy characterized by the presence of multiple, short-length core lesions (minicores) in both muscle fiber types. These lesions being nonspecific and the clinical phenotype being heterogeneous, multi-minicore disease boundaries remain unclear. To identify its genetic basis, we performed a genome-wide screening in a consanguineous Algerian family in which three children presented in infancy with moderate weakness predominant in axial muscles, pelvic girdle and hands, joint hyperlaxity (hand involvement phenotype), and multiple minicores. We mapped the disease to chromosome 19q13 in this family and, subsequently, in three additional families showing a similar phenotype, with a maximum LOD score of 5.19 for D19S570. This locus was excluded in 16 other multi-minicore disease families with predominantly axial weakness, scoliosis, and respiratory insufficiency ("classical" phenotype). In the Algerian family, we identified a novel homozygous missense mutation (P3527S) in the ryanodine receptor type 1 gene, a positional candidate gene responsible for the autosomal dominant congenital myopathy central core disease. New muscle biopsies from the three patients at adulthood demonstrated typical central core disease with rods; no cores were found in the healthy parents. This subgroup of families linked to 19q13 represents the first variant of central core disease with genetically proven recessive inheritance and transient presentation as multi-minicore disease.

Adolescent↗
PubMed1998

Hand and joint paths during reaching movements with and without vision.

This study examines whether the kinematics of pointing movements are altered by the sensory systems used to select spatial targets and to guide movement. Hand and joint paths of visually guided reaching movements of human subjects were compared with two non-visual conditions where only proprioception was available: (1) movements of the same subjects with blindfolds, and (2) movements by congenitally blind subjects. While hand-path curvatures were overall quite small, sighted subjects wearing a blindfold showed a statistical increase in hand-path curvature compared with their visually guided movements. Blindfolded subjects also showed greater hand-path curvature than blind subjects. These increases in hand-path curvature for blindfolded subjects did not always lead to a decrease in joint-path curvature. While there were differences between blind subjects and sighted subjects using vision for some movement directions, there was no systematic difference between these two groups. The magnitude of joint-path curvature showed much greater variation than hand-path curvature across the movement directions. We found variation in joint-path curvature to be correlated to two factors, one spatial and one geometrical. For all subject groups, joint-path curvature tended to be smaller for sagittal-plane movements than for transverse or diagonal movements. As well, we found that the magnitude of joint-path curvature was also related to the relative motion at each joint. Joint-path curvature tended to increase when movements predominantly involved changes in shoulder angle and was minimal when movements predominantly involved elbow motion. The consistently small curvatures of hand trajectory across blind and sighted subjects emphasize the powerful tendency of the motor system to generate goal-directed reaching movements with relatively straight hand trajectories, even when deprived of visual feedback from very early in life.

Adult↗
PubMed2001

Congenital true complete symphalangism of all proximal interphalangeal joints of hands with carpal anomalies: a case report.

Symphalangism is a rare condition which manifests in either PIP or DIP joint congenital fusion. Symphalangism may be with some other skeletal deformities. In our case, all PIP joints of both hands were fused with bilateral hypoplasia of carpal bones and Minaar type III lunatotriquetral coalition congenitally. No motion was detected in PIP joints with absence of cutaneous creases over all PIP joints. Radiologically, carpal hypoplasia and lunatotriquetral coalition were seen in all fingers with the absence of PIP joints. The patient's skeletal survey revealed no other pathology. He had no complaints related to his hands. So, regular follow-up was recommended. This pathology was presented as rarely observed although clinical problem is usually not so much.

Adolescent↗
PubMed2004

A two-year study of chondroitin sulfate in erosive osteoarthritis of the hands: behavior of erosions, osteophytes, pain and hand dysfunction.

The aim of this study was to evaluate the effect of 800 mg/die of chondroitin sulfate (CHS) per os plus naproxen versus naproxen over 2 years in patients with erosive osteoarthritis (EOA) of the hands. Joint count for erosions, Heberden and Bouchard nodes, Dreiser's algofunctional index and physicians' and patients' global assessment of disease activity were studied. A total of 24 consecutive patients (22 women and 2 men, mean age 53.0 +/- 6) suffering from symptomatic OA with radiographic characteristics of EOA were evaluated. The patients were divided into two groups of 12 patients each. The first group took naproxen 500 mg only. The second group was treated with CHS 800 mg orally plus naproxen 500 mg. Joint counts, radiological hand examinations and assessment of disease activity were performed at baseline, at 12 months and at 24 months. In the second year the treated group showed significant worsening in erosion, Heberden, Bouchard and Dreiser scores was recorded. Physician and patient global assessments of disease activity showed no significant difference from baseline scores. The untreated group showed significant worsening in erosion, Heberden and Bouchard nodes, Dreiser index and physician and patient global assessment scores. This study confirms the partial efficacy of oral CHS in improving some aspects of EOA.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1997

Internal fixation for small joint arthrodeses in the hand. The interphalangeal joints.

Interphalangeal arthrodeses are performed frequently for disabling pain and deformity in the proximal and distal interphalangeal joints. Such arthrodeses are the gold standard for eliminating pain in arthritic joints of the fingers. Kirschner wire fixation is simple to perform but often leads to nonunion or delayed union. Fixation with tension band wires and Herbert and Accutrak screws is discussed in this article. The techniques are simple and straightforward, and they afford considerably more stability and a higher union rate than Kirschner wires alone.

Arthritis↗
PubMed1993

Acute joint injuries of the hand.

The joints of the hand are stabilized by articular contours, tough ligamentous structures, and dynamically by a system of flexor and extensor tendons. Disruption of a joint seriously reduces the ability of the hand to function properly. The history and especially a detailed description of the mechanism of injury is invaluable information for the diagnosis and for the ability to anticipate complications. Radiographic evaluation is required for virtually all potential injuries. Multiple views and especially a true lateral view of the digit, when appropriate, are usually sufficient. The clinical examination includes the evaluation of (1) deformity, (2) swelling, (3) tendon and neurovascular status, (4) tests for stability, and (5) active and gentle passive range of motion. The most important aspect of treatment is the ability to distinguish between injuries that require surgery and those that can be splinted and referred for follow-up. In general a near full range of active motion indicates joint congruity, and the injury can be treated by splinting and referral to a hand surgeon.

Acute Disease↗
PubMed2000

Connective tissue disease and other related rheumatic conditions among patients with finger and hand and temporomandibular joint prostheses in Denmark.

OBJECTIVE: To determine if finger and hand joint prostheses or temporomandibular joint (TMJ) implants may be involved in the initiation of specific connective tissue diseases (CTD), a nationwide cohort in Denmark was followed prospectively to evaluate rates of CTD after receiving these implants. METHODS: Danish patients with finger and hand joint implants (n = 562) or TMJ implants (n = 351) were identified and followed for subsequent hospitalizations. Observed numbers of hospitalizations due to CTD were compared with expected numbers based on national CTD hospitalization rates. To avoid confounding by indication, patients with a hospital discharge diagnosis of a CTD prior to prosthetic surgery were excluded from the cohort. RESULTS: After 4142 person-years of followup in the finger and hand joint cohort, 9 hospitalizations due to CTD were found [standard hospitalization rate (SHR) = 1.5; 95% CI 0.7-2.9]. The TMJ cohort had 1500 person-years of followup and 2 hospitalizations due to CTD (SHR = 1.3; 95% CI 0.2-4.5). CONCLUSION: This is the first cohort study to examine the relations between these implants and CTD. Although the number of events was small, this systematic national study revealed no significant or large increase in risk of CTD after finger and hand joint implants or TMJ implants.

Aged↗
PubMed1980

Metacarpal cortical bone mass in patients with mandibular pain and dysfunction.

Sixty consecutive patients with mandibular pain and/or dysfunction were divided in three groups; one group with temporomandibular joint (TMJ) crepitation, another with tenderness on palpation of the TMJ and a reference group without any of these signs. The TM joints of the patients were exposed radiographically in oblique lateral and transmaxillary projections. The hands were exposed in the dorsovolar projection. The metacarpal index of Barnett & Nordin (2) (Formula: see text) was determined from the hand radiographs as well as the Exton-Smith (II) index (Formula: see text) Radiographic abnormalities in the TMJ and hand joints were recorded and quantified in indices as well as clinical abnormalities in the masticatory system. The index of Barnett & Nordin was significantly lower in the group of patients with palpatory tenderness of the TMJ than in the reference group. The Exton-Smith index was significantly and negatively correlated to the radiographic index of hand joint but not TMJ disease. A statistically significant positive correlation was found between the Exton-Smith index and the size of the TMJ condyle. The results of the present study indicate that patients with palpatory tenderness of the TMJ, probably of inflammatory origin, have a smaller second metacarpal cortical bone mass than reference patients, as have patients with radiographic signs of hand joint disease.

Age Factors↗
PubMed2004

A genome scan for joint-specific hand osteoarthritis susceptibility: The Framingham Study.

OBJECTIVE: Studies investigating hand osteoarthritis (OA) as a single entity have not shown strong linkage of the disease with any chromosomal sites. We undertook this study to test our hypothesis that phenotypes of hand OA may show stronger linkage than has been shown for overall hand OA. METHODS: We performed a factor analysis on measures of hand OA to determine patterns of disease. Using the joint regions identified by this analysis, we performed a genome-wide linkage analysis for OA susceptibility loci using 426 original cohort members and 790 offspring cohort members in 267 pedigrees. Radiographic OA features evaluated included the Kellgren/Lawrence score, osteophytes, and joint space narrowing. Prior to linkage analysis, standardized residuals were computed from regression analysis of each phenotype on age. This was performed separately for each sex and cohort. The variance component model (GeneHunter) was then applied to the normalized scores of the residuals of both sexes and cohorts. RESULTS: There was evidence suggestive of linkage (logarithm of odds [LOD] score >1.5) at 16 sites. Four of these sites had LOD scores >3.0. Two of these sites (identified in the full sample) included a linkage region for OA of the distal interphalangeal (DIP) joint on chromosome 7 (155 cM; LOD score 3.06) and a linkage region for OA of the first carpometacarpal (CMC) joint on chromosome 15 (81 cM; LOD score 6.25). The other 2 sites (identified in women) included a linkage region for OA of the DIP joint on chromosome 1 (202 cM; LOD score 3.03) and a linkage region for OA of the first CMC joint on chromosome 20 (4 cM; LOD score 3.74). CONCLUSION: These data suggest that several chromosomes contain hand OA susceptibility genes and that a joint-specific approach may be more rewarding than a global approach to the genetics of hand OA. Further investigation of these regions is warranted using finer maps and other populations.

Chromosome Mapping↗
PubMed1994

[Ultrasonography in the joints of hands with rheumatoid arthritis].

The findings of preoperative ultrasonography (US) in 37 joints of 12 patients with rheumatoid arthritis (RA) were evaluated and compared with clinical staging and operative findings. By US, synovial proliferation in the joints was observed as hypoechoic solid tumor. By dynamic examination of the metacarpophalangeal (MP) joints, the developmental process of joint immobilization could be detected through a close study of the relationship between the proliferated synovium and extensor tendons, synovial bursa, sagittal bands, and expansion hoods. As the cartilage and heads of the metacarpal bones and proximal phalanges could be demonstrated by dorsal scanning of the articular space of the over-flexed MP and proximal interphalangeal (PIP) joints, small synovial proliferation and irregular border of the cartilage could be detected during the early stage of inflammation. The findings of the present study showed that the application of preoperative US to RA patients was very useful for early diagnosis and for the selection of treatment, including operative methods.

Adult↗
PubMed2002

Acromegalic arthropathy of the hand with sesamoid involvement: a case report.

Acromegalic arthropathy may affect the hand joints with characteristic radiological changes. Sesamoid involvement in the hand may be presented with unusual changes. A case of a female patient with characteristic hand joint and sesamoid bone osteophytic changes related to acromegalic arthropathy is presented.

Acromegaly↗