Department of Rheumatology-Internal Medicine, Faculty of Medicine, Hatay Mustafa Kemal University, Hatay, Turkiye.
Department of Rheumatology-Physical Therapy and Rehabilitation, Faculty of Medicine, Samsun Ondokuz Mayıs University, Samsun, Turkiye.
Turk J Med Sci. 2024 Mar 23;54(4):766-770. doi: 10.55730/1300-0144.5847. eCollection 2024.
BACKGROUND/AIM: Rheumatoid arthritis (RA) usually affects the wrist, metacarpophalangeal joint, and proximal interphalangeal joint of the hands. However, the distal interphalangeal (DIP) joints may also be involved in RA patients. In this study, we aimed to evaluate the frequency and associated factors of DIP joint erosion in patients with RA.
Medical records of patients with RA were reviewed retrospectively. Patients with major trauma affecting DIP joints, osteoarthritis, erosive osteoarthritis, psoriatic arthritis, systemic sclerosis, calcium pyrophosphate dihydrate disease, and gout were excluded. Anteroposterior hand X-rays were evaluated and patients were divided into groups according to autoantibody profile.
We reviewed 1213 patients with a mean age of 54.3 ± 12.5 years; 82.8% of them were female, and 95.4% had RA-type erosive changes. The DIP erosion rate was 12%. DIP involvement was generally unilateral and asymmetric, with the 3rd finger being the most commonly affected joint. Patients with DIP erosions had a significantly longer disease duration (p = 0.036). Older age was an independent predictive factor for DIP erosion (p = 0.001).
In this large-sample study, we reported DIP joint involvement in patients with RA. Advanced age could have affected the results because hand erosions increase above 50 years in a healthy population. Our results may provide a different perspective on joint involvement in RA.
背景/目的：类风湿关节炎（RA）通常影响手部的腕关节、掌指关节和近端指间关节。然而，远端指间（DIP）关节也可能受累于 RA 患者。在这项研究中，我们旨在评估 RA 患者 DIP 关节侵蚀的频率及其相关因素。
回顾性审查了 RA 患者的病历。排除了有影响 DIP 关节的主要创伤、骨关节炎、侵蚀性骨关节炎、银屑病关节炎、系统性硬化症、焦磷酸钙二水合物病和痛风的患者。评估了前后手 X 光片，并根据自身抗体谱将患者分为不同的组。
我们回顾了 1213 名平均年龄为 54.3±12.5 岁的患者；其中 82.8%为女性，95.4%有 RA 样侵蚀性改变。DIP 侵蚀率为 12%。DIP 受累通常为单侧和不对称性的，第 3 指是最常受影响的关节。DIP 侵蚀的患者疾病持续时间明显更长（p=0.036）。年龄较大是 DIP 侵蚀的独立预测因素（p=0.001）。
在这项大样本研究中，我们报告了 RA 患者的 DIP 关节受累情况。由于在健康人群中，手部侵蚀在 50 岁以上时会增加，因此年龄较大可能会影响结果。我们的结果可能为 RA 的关节受累提供了不同的视角。
