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At least 1,243 records · Page 69Linked to original sources
PubMed2006

Radiographic joint space width in the fingers of patients with rheumatoid arthritis of less than one year's duration.

OBJECTIVE: To determine the radiographic joint space width (JSW) in undamaged metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints of patients with early rheumatoid arthritis (RA) and to identify important clinical determinants of JSW. METHODS: Radiographs of patients with RA of <1 year's duration, from an early arthritis cohort at a tertiary care rheumatology clinic, were obtained. JSW was analyzed by joint, finger, age, sex, height, and a number of other clinically relevant variables. Multivariate analysis was also performed, to account for possible confounding between variables. RESULTS: Thirty-eight patients were included in the study. We found that JSW was greater in the MCP joint than the PIP joint (P < 0.0001). JSW was significantly greater in men (P < 0.0001) and increased with increasing height (P < 0.003), but was not associated with age (P < 0.21). In multivariate analyses, sex was shown to be the most important predictor of JSW. CONCLUSION: In patients with early RA, MCP and PIP JSW is significantly associated with sex and height. In studies of RA in which JSW measurements are included as an outcome, these differences may need to be accounted for in the analysis.

Arthritis, Rheumatoid↗
PubMed1998

Distribution of collagens and glycosaminoglycans in the joint capsule of the proximal interphalangeal joint of the human finger.

BACKGROUND: The capsule of the proximal interphalangeal joint consists of the central slip of the extensor tendon dorsally, the collateral ligaments at the sides and the palmar ligament ventrally. Fibrocartilaginous menisci have been reported extending into the joint cavity and the central slip has a sesamoid fibrocartilage articulating with the proximal phalanx. This study relates ECM composition in the joint capsule to function. METHODS: Each part of the capsule from 24 fingers amputated because of trauma, carcinoma, isthaemia, fixed-flexion deformities or Dupuytren's contracture, was dissected out. Sections were prepared for routine histology or immunolabelled with a panel of monoclonal and polyclonal antibodies against collagens and glycosaminoglycans using the avidin/biotin/peroxidase procedure. RESULTS: All parts of the capsule consistently labelled for types I, III and VI collagens and for dermatan and keratan sulphate, though labelling was more pericellular in fibrocartilaginous regions. In contrast, only certain regions of the capsule in some fingers labelled for type II collagen, chondroitin 4 or 6 sulphate. The sesamoid fibrocartilage in the central slip showed the greatest degree of fibrocartilage differentiation, especially in fixed-flexion deformity fingers, and the palmar ligament the least. CONCLUSIONS: The immunolabelling patterns suggest that there is an ordered sequence of matrix changes accompanying fibrocartilage differentiation. Chondroitin sulphate-containing proteoglycans accumulate first, and type II collagen appears later. The presence or absence of type II collagen probably relates to different levels of compressive loading. No fibrocartilaginous menisci were found in normal joints and those described previously are regarded as synovial folds.

Adolescent↗
PubMed1987

The effect of digital nerve block on position sense at the proximal interphalangeal joint of the human index finger.

Position matching at the proximal interphalangeal joint of the index finger in human subjects was tested by passive displacement of the right (target) finger and active matching of the left index finger. In 5 subjects it was found that position matching was grossly impaired after digital nerve block of the matching finger. Typically, subjects hyperextended the matching finger when the target finger was held in extension and hyperflexed the matching finger when the target finger was held in flexion. These results suggest that even with active positioning, joint and cutaneous receptors importantly contribute to the awareness of position at this joint.

Adult↗
PubMed1983

Proprioceptive sensation at the terminal joint of the middle finger.

This paper extends previous work (Gandevia & McCloskey, 1976) on proprioception in the terminal joint of the middle finger. By positioning the finger in appropriate ways proprioceptive acuity at the joint can be assessed when no muscular afferents could contribute, or when afferents in the flexor but not the extensor could contribute, or when afferents from both muscles could contribute. Digital nerve block anaesthetizes joint and cutaneous receptors and so was used to study the contributions from muscle afferents in isolation. Displacements (10 degrees) at various angular velocities were better detected when muscle afferents from both flexor and extensor muscles could contribute. This was so whether joint and cutaneous receptors were also available, or after digital anaesthesia. Performance when only muscle afferents are available is, however, inferior to that when all sensory mechanisms are intact. It is concluded that muscle afferents contribute to kinaesthesia, and that a full complement of such receptors from agonist and antagonist muscles gives superior acuity to that achieved when only the receptors of one of the muscle groups is available. The angular displacements necessary for 70% correct detection were determined at angular velocities between 0.25 degrees and 160 degrees/s. Proprioceptive performance was optimal with all proprioceptive mechanisms intact over the range of angular velocities 10 degrees -80 degrees/s: 70% correct detection of displacements of 0.8 degrees-1.2 degrees occurred in this range. Performance deteriorated slightly at higher velocities of displacement. Performance was significantly poorer when only joint and cutaneous receptors could contribute (in the absence of intramuscular receptors), and when only intramuscular receptors could contribute (in the absence of joint and cutaneous receptors). Full proprioceptive acuity depends upon the availability of receptors in muscles and in skin and/or joints.

Finger Joint↗
PubMed1996

Entrapment of the metacarpophalangeal joint of the middle finger. Case report.

Locking of the second metacarpal joint is common, but locking of other metacarpal joints is unusual. We present a case, in which the joint of the third finger locked and the mechanism was an osteophyte catching of the ulnar accessory collateral ligament. In such a case, the joint should be explored through a palmar approach. Conservative treatment is not recommended.

Collateral Ligaments↗
PubMed1999

Finger kinaesthesia: cognitive electrogeneses to attended joint input.

Study of brain mechanisms subserving perception of passive finger movements revealed an unexpected contrast between cutaneous and deep inputs from fingers. Selective attention to tactile inputs from finger tips did not change the first response of primary area 3b, but elicited a cognitive P40 in second order postcentral cortex. For finger joint inputs, attention enhanced the very first cortical response elicited by thalamo-cortical input in postcentral area 2 whereby finger kinaesthesia information was integrated with the cutaneous features information received from primary somatic areas via corticocortical connections. Cognitive electrogeneses P40, P100, N140 and P300 manifested serial sensory features processing and prefrontal working memory matching whereby manipulated objects can be identified from their shape and texture in active touch.

Adult↗
PubMed2000

[Linburg-Comstock syndrome. Epidemiologic and anatomic study, clinical applications].

The Linburg-Comstock (LC) syndrome is distinguished by the inability to actively flex the interphalangeal (IP) joint of the thumb without simultaneously flexing the distal IP joint of the index finger. Any resistance to this 'parasitic' reaction causes pain on the palmar side of the wrist or in the distal part of the forearm; this is due to an anomalous tendinous connection between the flexor pollicus longus (FPL) and the flexor digitorum profundus (FDP). An epidemiological study was carried out on 264 individuals (a total of 528 hands were examined), and the LC syndrome was found in 98 subjects (37%); women were more frequently affected than men, and bilaterally rather than unilaterally. In addition, we dissected 26 fresh cadaver upper limbs, and in seven cases found an anomalous connection between FPL and FDP. We also examined the case of a young violinist with bilateral LC syndrome, who complained of pain in the distal part of the left forearm after prolonged musical exercises. Surgical investigation determined a complete fusion between FPL and FDP of the index with a common tendon. Treatment consisted of splitting this common tendon to form two separate tendons, thereby permitting a certain degree of independence between the thumb and index finger, and which considerably improved the violinist's musical performance. A review of the literature showed that there was a large quantity of anatomical descriptions available on these types of connection. Certain publications also provide an extremely precise report on the anthropological significance of these anomalies.

Adolescent↗
PubMedDate not supplied

Distal symphalangism: a report of two families.

This study describes distal symphalangism in 36 individuals in two families, one of which is the largest pedigree of this rare defect yet documented. Distal symphalangism is ankylosis or rigidity of the distal interphalangeal joints of the hands and/or feet. The findings of this report substantiate the mutation as an autosomal dominant phenotype. Several manifestations of distal symphalangism were observed, including the lack of cutaneous creases over affected joints, brachydactyly, fourth-finger hypophalangism, absent nails, and rudimentary nails. Variability ranged from just toes affected, to a single finger affected, to all fingers and all lesser toes affected. The most common expression of the mutant gene was rigid index fingers. Craniosynostosis, premature closure of the sutures of the skull, was encountered twice in the larger of the two families. It is a possible pleiotropic effect of distal symphalangism.

Adolescent↗
PubMed2006

Primary osteoarthritis in the ankle joint is associated with finger metacarpophalangeal osteoarthritis and the H63D mutation in the HFE gene: evidence for a hemochromatosis-like polyarticular osteoarthritis phenotype.

BACKGROUND AND AIM: Osteoarthritis (OA) can occur in the ankle joint. It also occurs in an appreciable proportion of subjects with hereditary hemochromatosis (HH). Might these conditions have common genetic characteristics? The aim of this study was to test the hypothesis that HFE gene mutations are associated with primary osteoarthritis in the ankle joint. METHODS: Consecutive referred patients who had primary or secondary (posttraumatic) OA of the ankle joint were assessed by a single rheumatologist and had a full physical and joint examination. Plain x-rays of the ankle joint, other clinically involved osteoarthritic joints, iron studies, HFE genotyping, and Hb electrophoresis were performed. The significance of differences was evaluated by 2-tailed Fisher exact test. RESULTS: Fourteen patients met the inclusion criteria for primary ankle OA and 6 met the criteria for secondary ankle OA. One of the 14 had had a previous subtalar joint fusion and was excluded. Among the remaining 13, 7 had OA in the index and/or middle finger metacarpophalangeal joints (MCP2,3 OA) with radiologic features similar to those found in hemochromatotic arthropathy (HA). Furthermore, 11 of the 13 had at least one HFE mutation, one subject in this group was homozygous for H63D, one was compound heterozygous for C282Y and S65C, and one was compound heterozygous for H63D and S65C. Eight were heterozygous for H63D. The 13 subjects were compared with the 6 secondary ankle OA subjects and with a previously studied population cohort (n = 3011) from the town of Busselton in whom HFE genotyping had been performed. A statistically significant increase in the frequency of HFE gene mutations was observed in the group with primary OA of the ankle joint compared with that with secondary ankle joint OA (P = 0.0095) and compared with the Busselton cohort (P = 0.0008). Furthermore, a statistically significant association between finger MCP joint OA and primary ankle joint OA was observed (P = 0.0436). Iron studies were normal in the 13 primary and 6 secondary ankle OA subjects. None of the subjects with ankle OA had clinical signs of hemochromatosis or abnormal liver function tests. CONCLUSIONS: A strong and statistically significant association was observed between HFE gene mutations and primary OA in the ankle joint. The frequent presence of MCP2,3 OA in these patients suggests the existence of a type 2 polyarticular OA phenotype that closely resembles the arthropathy of HH and which appears to be clinically differentiable from type 1 OA or nodal generalized OA (NGOA). HFE gene mutations may be a marker for the type 2 polyarticular OA phenotype and a clue to OA pathogenesis.

Adult↗
PubMed1993

Ligamentous injuries of multiple interphalangeal joints of the little finger: case report.

Ligamentous injuries to multiple interphalangeal joints of an extremity have seldom been reported. We treated a patient with multiple ligamentous injuries in the little finger. Manual reduction of the distal interphalangeal (DIP) joint and surgical repair of the radial collateral ligament were performed to correct multidimensional joint instability and to allow for rehabilitation.

Finger Injuries↗
PubMed1985

Joint injuries of the fingers and thumb.

Prompt recognition of the magnitude of articular damage is essential for optimal management of digital joint injuries. Basic to this concept is the need to differentiate injuries that can be successfully treated by closed techniques from those that require surgery. Following an accurate restoration of the damaged joint, recovery of function depends on careful immobilization in a protective position and, whenever possible, early joint mobilization. Precise primary care is the key to the prevention of disabling joint contractures.

Contracture↗
PubMed1984

Dorsal dislocation of the fourth and fifth carpometacarpal joints and simultaneous dislocation of the metacarpophalangeal joint of the small finger: a case report.

A patient with dorsal dislocation of the fourth and fifth carpometacarpal (CMC) joints and dislocation of the metacarpophalangeal (MP) joint of the small finger was managed successfully by open reduction and transarticular fixation of the CMC joint dislocation and closed reduction of the MP joint dislocation. This rare combination of injuries has not been reported previously.

Adult↗
PubMed1998

Functional distal interphalangeal joint splinting for trigger finger in laborers: a review and cadaver investigation.

This two-part study evaluates the efficacy of functional distal interphalangeal joint (DIP) splinting for the treatment of trigger finger. Thirty-one fingers from 21 meat packing plant workers were treated with DIP splinting. A single corticosteroid injection was offered if triggering was stage 4 or greater. All workers returned to work immediately. Eighty-one percent of the digits were treated successfully (mean follow-up: 1 year). Treatment failure correlated with duration of symptoms and stage of triggering but did not correlate with age, race, sex, disease in multiple digits, or prior treatment. For the second part of the study, the effect of DIP splinting on flexor digitorum profundus (FDP) tendon excursion was studied in 16 fingers from 4 fresh cadavers. Excursion decreased 4.8 mm for the Stax splint and 4.2 mm for the dorsal Alumafoam splint. We conclude that DIP splinting provides a reliable and functional means of treating work-related trigger finger without lost time from work. Our cadaver investigation supports our theory that DIP splinting significantly decreases FDP excursion.

Adult↗