Ketenci Sertaç, Pekdiker Mete, Uzuner Bora, Durmuş Dilek
Department of Rheumatology, Ondokuz Mayıs University, Samsun, Türkiye.
Department of Rheumatology, Hatay Mustafa Kemal University, Hatay, Türkiye.
Arch Rheumatol. 2025 Jun 23;40(2):164-170. doi: 10.5152/ArchRheumatol.2025.11108.
Background/Aims: Rheumatoid arthritis (RA) is characterized by significant inflammation and joint damage. This study aims to investigate the frequency of abnormal ulnar variance (AUV) in RA patients and its associated factors. Materials and Methods: A total of 108 established RA patients meeting the 2010 ACR/EULAR RA criteria were included. After exclusions, the study proceeded with 98 patients. Demographic, laboratory, and clinical data were recorded. X-rays of the wrists were taken in accordance with the literature, with the forearm in a neutral rotation, the elbow flexed at 90°, the shoulder abducted at 90°, and ulnar variance was assessed with Hulten's method. A displacement of 1 mm or more of the ulna relative to the radius was defined as AUV. Results: The average age was 58.11 ± 12.05 years, with 82% being female. The mean disease duration was 175.16 ± 100.5 months, and the average diagnostic delay was 16.4 ± 11.18 months. Abnormal ulnar variance was present in 47.9% of patients. In patients with AUV, the average UV for the right hand was +2.24 mm, while the average for the left hand was +2.40 mm. When considering all RA cases, the average UV was +1.06 mm for the right hand and +1.09 mm for the left hand. In the multivariate analysis, RA-type joint involvement (RJI) and severe joint involvement (SJI) were identified as independent predictors of AUV. Conclusion: This study suggests that AUV may be an important finding in established RA. Future larger-scale and prospective studies are needed to elucidate the significance of AUV in RA cases.
背景/目的：类风湿关节炎（RA）的特点是存在明显炎症和关节损伤。本研究旨在调查RA患者中尺骨变异异常（AUV）的发生率及其相关因素。材料与方法：共纳入108例符合2010年美国风湿病学会/欧洲抗风湿病联盟（ACR/EULAR）RA标准的确诊RA患者。排除部分患者后，研究纳入98例患者。记录人口统计学、实验室及临床数据。按照文献要求拍摄腕部X线片，前臂处于中立旋转位，肘部屈曲90°，肩部外展90°，采用胡尔滕（Hulten）法评估尺骨变异。尺骨相对于桡骨移位1mm或更多定义为AUV。结果：平均年龄为58.11±12.05岁，女性占82%。平均病程为175.16±100.5个月，平均诊断延迟为16.4±11.18个月。47.9%的患者存在尺骨变异异常。在AUV患者中，右手平均尺骨变异为+2.24mm，左手平均为+2.40mm。在所有RA病例中，右手平均尺骨变异为+1.06mm，左手平均为+1.09mm。多因素分析中，RA型关节受累（RJI）和严重关节受累（SJI）被确定为AUV的独立预测因素。结论：本研究提示AUV可能是确诊RA的一项重要发现。未来需要开展更大规模的前瞻性研究以阐明AUV在RA病例中的意义。
