Bagis Selda, Sahin Gunsah, Yapici Yasemin, Cimen Ozlem Bolgen, Erdogan Canan
Department of Physical Medicine and Rehabilitation, Mersin University Medical School, Mersin, Turkey.
Clin Rheumatol. 2003 Dec;22(6):420-4. doi: 10.1007/s10067-003-0792-4. Epub 2003 Nov 5.
The aim of the study was to investigate the effect of osteoarthritis on hand function in postmenopausal women. One hundred patients with hand OA and 70 healthy volunteers as controls were evaluated. Grip and pinch strength measurements and Dreiser's functional index were used for hand function. Pain was assessed by a visual analog scale, and tenderness was assessed by palpation and scored, depending on the severity of tenderness, as 0, 1 or 2. Heberden's and Bouchard's nodules and joint involvement were also recorded. The number of patients with only distal interphalangeal joint involvement was 50 (50%), those with distal interphalangeal joint plus proximal interphalangeal joint involvement was 49 (49%), and those with carpometacarpal joint involvement numbered 18 (18%). The incidence of Heberden's and Bouchard's nodules was 85% and 36%, respectively. Eighty-six (86%) patients were suffering from pain and 57 were found to have tenderness. Grip and pinch strength was significantly lower (p<0.05) and Dreiser's functional index score was significantly higher (p<0.001) in the study group (particularly in grade 4 OA). Grip strength was lower in hand OA patients with distal interphalangeal joint plus proximal interphalangeal joint involvement than in those with only distal interphalangeal joint and carpometacarpal joint involvement. Pinch strength was also lower in patients with distal interphalangeal joint plus proximal interphalangeal joint plus carpometacarpal joint involvement. The patients with Heberden's and Bouchard's nodules had lower grip and pinch strength than controls. Also, pain and tenderness had significant (p<0.05) effects on hand function. Dreiser's total score ranged from 0 to 10 in 80 (80%) patients and from 11 to 20 in 20 patients. In conclusion, hand osteoarthritis contributes to hand dysfunction, mainly related to the severity of osteoarthritis, pain, joint involvement and the presence of nodules.
本研究的目的是调查骨关节炎对绝经后女性手部功能的影响。对100例手部骨关节炎患者和70名健康志愿者作为对照进行了评估。使用握力和捏力测量以及德雷泽功能指数来评估手部功能。通过视觉模拟量表评估疼痛,并通过触诊评估压痛并根据压痛的严重程度评分为0、1或2。还记录了赫伯登结节和布夏尔结节以及关节受累情况。仅远端指间关节受累的患者有50例(50%),远端指间关节加近端指间关节受累的患者有49例(49%),腕掌关节受累的患者有18例(18%)。赫伯登结节和布夏尔结节的发生率分别为85%和36%。86例(86%)患者有疼痛,57例有压痛。研究组(特别是4级骨关节炎患者)的握力和捏力显著降低(p<0.05),德雷泽功能指数评分显著升高(p<0.001)。远端指间关节加近端指间关节受累的手部骨关节炎患者的握力低于仅远端指间关节和腕掌关节受累的患者。远端指间关节加近端指间关节加腕掌关节受累的患者捏力也较低。有赫伯登结节和布夏尔结节的患者的握力和捏力低于对照组。此外,疼痛和压痛对手部功能有显著(p<0.05)影响。80例(80%)患者的德雷泽总分在0至10分之间,20例患者在11至20分之间。总之,手部骨关节炎会导致手部功能障碍,主要与骨关节炎的严重程度、疼痛、关节受累情况和结节的存在有关。