Kowalski Brooke, Zarkadis Nicholas J, Harris Mitchell, Scanaliato John, Dunn John
Madigan Army Medical Center, Joint Base Lewis-McChord, WA, USA.
Blanchfield Army Community Hospital, Fort Campbell, KY, USA.
Hand (N Y). 2024 Jun 22:15589447241260766. doi: 10.1177/15589447241260766.
The purpose of this systematic review is to describe the pathoanatomy, presentation, diagnostic workup, treatment modalities, and outcomes of posterior interosseous nerve (PIN) palsy in patients with rheumatoid arthritis (RA). All reported cases of PIN palsy in patients with RA were reviewed to yield 72 cases of PIN palsy in 70 patients. The male-to-female ratio was 1:2.7. Pain involving the elbow was very common (20/33 cases reporting this information), and paralysis or weakness of digit extension was noted in 27/33 cases and 6/33 cases, respectively. Only 1 of the 54 cases undergoing surgical intervention reported persistent weakness, and this 1 patient had undergone a 3-month trial of conservative management. In conclusion, Appropriate pharmacologic management in conjunction with magnetic resonance imaging (MRI) and ultrasound monitoring may be used for conservative management, but surgical decompression should still be utilized for patients with a compressive disease pathology who fail to improve with 6 weeks of conservative treatment, or for those with advanced disease on initial presentation.
本系统评价的目的是描述类风湿关节炎（RA）患者后骨间神经（PIN）麻痹的病理解剖、表现、诊断检查、治疗方式及结果。对所有报道的RA患者PIN麻痹病例进行回顾，共纳入70例患者的72例PIN麻痹病例。男女比例为1:2.7。涉及肘部的疼痛非常常见（33例中有20例报告了此信息），分别有27/33例和6/33例出现手指伸展麻痹或无力。接受手术干预的54例患者中只有1例报告持续存在无力，该患者曾接受3个月的保守治疗试验。总之，适当的药物治疗结合磁共振成像（MRI）和超声监测可用于保守治疗，但对于压迫性疾病病理且经6周保守治疗无改善的患者，或初次就诊时病情晚期的患者，仍应采用手术减压治疗。
