Rheumatoid arthritis of the hand: a five-year longitudinal analysis of clinical and radiographic findings

Toyama, Shogo; Tokunaga, Daisaku; Fujiwara, Hiroyoshi; Oda, Ryo; Kobashi, Hiroaki; Okumura, Hisashi; Nakamura, Satoru; Taniguchi, Daigo; Kubo, Toshikazu

doi:10.1007/s10165-013-0859-2

Cited by 7 publications

(11 citation statements)

References 18 publications

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“…Changes can include progressive periarticular bone thinning (osteopenia) and development of resorptive bone lesions (erosions) [5,6]. Periarticular bone damage, most commonly seen in the bone near the metacarpal phalangeal and wrist joints, can contribute to the development of hand deformities and profound functional limitations in people living with RA [6,7]. Additionally, systemic extra-articular inflammatory bone changes contribute to a two-fold increase in fracture risk with aging in people living with RA [8-11].…”

Section: Introductionmentioning

confidence: 99%

A customized protocol to assess bone quality in the metacarpal head, metacarpal shaft and distal radius: a high resolution peripheral quantitative computed tomography precision study

Feehan

Buie

et al. 2013

BMC Musculoskelet Disord

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BackgroundHigh Resolution-Peripheral Quantitative Computed Tomography (HR-pQCT) is an emerging technology for evaluation of bone quality in Rheumatoid Arthritis (RA). However, there are limitations with standard HR-pQCT imaging protocols for examination of regions of bone commonly affected in RA. We developed a customized protocol for evaluation of volumetric bone mineral density (vBMD) and microstructure at the metacarpal head (MH), metacarpal shaft (MS) and ultra-ultra-distal (UUD) radius; three sites commonly affected in RA. The purpose was to evaluate short-term measurement precision for bone density and microstructure at these sites.Methods12 non-RA participants, individuals likely to have no pre-existing bone damage, consented to participate [8 females, aged 23 to 71 y [median (IQR): 44 (28) y]. The custom protocol includes more comfortable/stable positioning and adapted cortical segmentation and direct transformation analysis methods. Dominant arm MH, MS and UUD radius scans were completed on day one; repeated twice (with repositioning) three to seven days later. Short-term precision for repeated measures was explored using intraclass correlational coefficient (ICC), mean coefficient of variation (CV%), root mean square coefficient of variation (RMSCV%) and least significant change (LSC%95).ResultsBone density and microstructure precision was excellent: ICCs varied from 0.88 (MH2 trabecular number) to .99 (MS3 polar moment of inertia); CV% varied from < 1 (MS2 vBMD) to 6 (MS3 marrow space diameter); RMSCV% varied from < 1 (MH2 full bone vBMD) to 7 (MS3 marrow space diameter); and LSC% 95varied from 2 (MS2 full bone vBMD to 21 (MS3 marrow space diameter). Cortical porosity measures were the exception; RMSCV% varying from 19 (MS3) to 42 (UUD). No scans were stopped for discomfort. 5% (5/104) were repeated due to motion during imaging. 8% (8/104) of final images had motion artifact graded > 3 on 5 point scale.ConclusionIn our facility, this custom protocol extends the potential for in vivo HR-pQCT imaging to assess, with high precision, regional differences in bone quality at three sites commonly affected in RA. Our methods are easy to adopt and we recommend other users of HR-pQCT consider this protocol for further evaluations of its precision and feasibility in their imaging facilities.

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Section: Introductionmentioning

confidence: 99%

A customized protocol to assess bone quality in the metacarpal head, metacarpal shaft and distal radius: a high resolution peripheral quantitative computed tomography precision study

Feehan

Buie

et al. 2013

BMC Musculoskelet Disord

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“…For health‐related factors, conflicting evidence was found regarding the relationship between hand function and disease duration and general health status. Long disease duration was expected to be significantly associated with poor hand function, since hand impairments are prevalent and deteriorate over time in patients with long disease duration . Alongside, the limitations mentioned earlier concerning the methodologies of the included studies, a possible explanation for this finding might be related to the fact that patients with long disease duration may have adapted to their situation and they do not expect any effective treatment to be available .…”

Section: Discussionmentioning

confidence: 96%

Factors Associated With Hand and Upper Arm Functional Disability in People With Rheumatoid Arthritis: A Systematic Review

Alkabeya

Hughes

Adams

2019

Arthritis Care & Research

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Objective. This original systematic review aimed to summarize evidence within observational studies on the factors associated with hand functional disability in adults with rheumatoid arthritis (RA).Methods. A rigorous extensive systematic literature search was conducted in 6 medical databases for peerreviewed English language observational studies that explore the factors associated with hand function for people with RA. Factors were critically classified under the domains of the International Classification of Functioning, Disability and Health (ICF) framework and health-related factors. The methodologic quality was determined using the appraisal tool for cross-sectional studies. Factors related to hand function that were investigated in ≥2 studies were explored using a best-evidence synthesis.Results. Twenty articles from 1,271 citations met the inclusion criteria. All presented cross-sectional data (5 high-quality and 15 low-quality articles), resulting in limited evidence in the best-evidence synthesis. For the factors classified under the ICF domains, the best-evidence synthesis indicated that a diverse range of positive and negative factors were associated with hand function. However, key factors were hand strength, disease activity, and pain intensity. It is evident that few sociodemographic factors have been explored for the association with hand function.Conclusion. Although the level of evidence was limited, modifiable factors such as grip strength, disease activity, and pain were identified as the most influential factors on hand function in people with RA. The findings of the present review indicate that important sociodemographic factors that impact hand function in individuals with RA have not yet been considered or reported in clinical research.Presented by Mr. Arab Alkabeya in partial fulfillment of the requirements for a

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“…Until recently (Toyama et al, 2014 ), there were few longitudinal studies tracking the evolution of morphological changes in the hand (deformities and erosions typically detected in radiographs), and none that systematically evaluated functional abilities. Toyama et al ( 2014 ) conducted a 5-year longitudinal study regarding deformity evolution over time.…”

Section: The Case For a Data-driven Gamementioning

confidence: 99%

“…Toyama et al ( 2014 ) conducted a 5-year longitudinal study regarding deformity evolution over time. Their analyses consisted of radiographic evaluation of deformities using the Sharp/van der Heijde scoring system (van der Heijde, 1996 ), functional evaluation using a goniometer (which measures angles of joints), and several questionnaires.…”

Section: The Case For a Data-driven Gamementioning

confidence: 99%

“…What if I take drug option B?" Particularly relevant to serious games and simulations was Toyama et al's ( 2014 ) use of an instrument called JSSH (Japanese Disability of the Arm Shoulder and Hand). The JSSH score is computed based on answers to 20 Likert (0 to 3) questions regarding daily living activities (e.g., Can you hold a glass?…”

Section: The Case For a Data-driven Gamementioning

confidence: 99%

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Loh¹,

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Ifenthaler³

2015

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Rheumatoid arthritis of the hand: a five-year longitudinal analysis of clinical and radiographic findings

Cited by 7 publications

References 18 publications

A customized protocol to assess bone quality in the metacarpal head, metacarpal shaft and distal radius: a high resolution peripheral quantitative computed tomography precision study

A customized protocol to assess bone quality in the metacarpal head, metacarpal shaft and distal radius: a high resolution peripheral quantitative computed tomography precision study

Factors Associated With Hand and Upper Arm Functional Disability in People With Rheumatoid Arthritis: A Systematic Review

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