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Druel T, Budai A, Gazarian A. Trapeziometacarpal osteoarthritis: do not forget other disorders. J Hand Surg Eur Vol 2024; 49:920-921. [PMID: 38069838 DOI: 10.1177/17531934231220644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/29/2024]
Abstract
A retrospective study of patients with symptomatic trapeziometacarpal osteoarthritis was conducted to assess the prevalence of other disorders of the hand. Another disorder of the hand was associated in 49% of cases. A systematic clinical examination of the whole hand must be performed preoperatively.
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Affiliation(s)
- Thibault Druel
- Department of Hand Surgery, Hôpital Edouard Herriot, Hospices Civil de Lyon, Lyon, France
| | - Alexandre Budai
- Department of Hand Surgery, Hôpital Edouard Herriot, Hospices Civil de Lyon, Lyon, France
| | - Aram Gazarian
- Department of Hand Surgery, Hôpital Edouard Herriot, Hospices Civil de Lyon, Lyon, France
- Department of Hand Surgery, Clinique du Parc, Lyon, France
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Chen S, Ho T, Asubonteng J, Sobel RE, Eng S, DiMartino SJ, Manthripragada A. Risk of carpal tunnel syndrome among patients with osteoarthritis: a US population-based study. BMC Musculoskelet Disord 2024; 25:468. [PMID: 38879540 PMCID: PMC11179394 DOI: 10.1186/s12891-024-07459-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 04/19/2024] [Indexed: 06/19/2024] Open
Abstract
BACKGROUND Carpal tunnel syndrome (CTS), an entrapment neuropathy caused by pressure of the median nerve, is a progressive condition that can lead to a decreased quality of life. Studies suggest an association between CTS and arthritis; however, previous studies examining osteoarthritis (OA) and CTS are limited in number, scope and study design. This study estimated the incidence and risk of CTS among patients with OA, both overall and by specific joints, in a large population-based cohort in the United States. METHODS Patients from the Optum claims database aged ≥ 45 years and diagnosed with OA between January 1, 2018, and December 31, 2022, were eligible for the OA cohort. The non-OA cohort included those without a diagnosis of OA at the index date and no history of OA for 12 months pre-index. Baseline characteristics were balanced using propensity score matching. The risk of CTS in the OA and non-OA cohort were evaluated using incidence rates and adjusted hazard ratios that were estimated using Cox regression. RESULTS After applying the inclusion/exclusion criteria, 3,610,240 of the 6,023,384 adults with a diagnosis of OA remained in the OA cohort. After propensity-score matching, each cohort included 1,033,439 individuals. The incidence rates for CTS per 1000 person-years were 7.35 (95% confidence interval [CI] 7.21-7.49) in the OA cohort and 1.44 (95% CI 1.38-1.50) in the non-OA cohort. The risk of developing CTS in patients with OA was ~ 4 times that of patients without (hazard ratio = 3.80; 95% CI 3.54-4.07). This increased risk was found across all OA joint types, with OA of the hand/wrist having the highest risk for CTS. Additionally, multiple OA joints presented a higher risk compared with a single affected joint. CONCLUSIONS OA increases the risk of CTS, but this is not limited to patients with hand/wrist OA, suggesting a systemic impact of OA on CTS. While the risk appears highest for patients with hand/wrist OA, patients with more distant affected joints like knee or hip also have an increased risk of CTS.
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Affiliation(s)
- Shuang Chen
- Regeneron Pharmaceuticals, Inc., 777 Old Saw Mill River Road, Tarrytown, NY, USA.
| | - Tina Ho
- Regeneron Pharmaceuticals, Inc., 777 Old Saw Mill River Road, Tarrytown, NY, USA
| | - Julius Asubonteng
- Regeneron Pharmaceuticals, Inc., 777 Old Saw Mill River Road, Tarrytown, NY, USA
| | - Rachel E Sobel
- Regeneron Pharmaceuticals, Inc., 777 Old Saw Mill River Road, Tarrytown, NY, USA
| | - Simon Eng
- Regeneron Pharmaceuticals, Inc., 777 Old Saw Mill River Road, Tarrytown, NY, USA
| | - Stephen J DiMartino
- Regeneron Pharmaceuticals, Inc., 777 Old Saw Mill River Road, Tarrytown, NY, USA
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Alendijani YA, Abaalkhail BA, Binsaeedu AS, Alandijani AA. Risk factors for carpal tunnel syndrome in patients attending the primary care center of a tertiary hospital in Riyadh, Saudi Arabia: A case-control study. J Family Community Med 2023; 30:81-88. [PMID: 37303839 PMCID: PMC10252633 DOI: 10.4103/jfcm.jfcm_361_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 01/25/2023] [Accepted: 02/18/2023] [Indexed: 06/13/2023] Open
Abstract
BACKGROUND Carpal tunnel syndrome (CTS), the most common entrapment neuropathy in the upper extremity, is known to be a multi-factorial disease that raises medical and nonmedical risk factors. The aim of the current study was to determine the risk factors of CTS in patients attending the primary care center at a tertiary hospital. MATERIALS AND METHODS A case-control study was conducted by reviewing all medical records of patients above the age of 18 years old diagnosed with CTS from 2015 to 2021. The selected cases were evaluated by physical examination and confirmed by a nerve conduction study. Cases and controls were matched by age, gender, and nationality, with a case-to-control ratio of 1:2. Odds ratios were calculated for association between carpel tunnel syndrome and various factors and Chi-sqauare test determined statistical significance. Multiple logistic regression was performed to adjust for confounding. RESULTS The study recruited 144 cases with a mean age of 53.38 ± 12.20 years and 288 controls with a mean age of 53.80 ± 12.27 years. The majority of subjects were female (84.7%) and of Saudi nationality (68.3%). There was a significant difference in body mass index, employment status, number of years of employment, occupation, mean systolic blood pressure, mean low-density lipoprotein cholesterol level, and mean blood urea level between cases and controls (P < 0.05). Laboratory tests that were found to be significantly associated with CTS in univariate analysis were thyroid-stimulating hormone (crude odds ratio [COR] = 0.828) and urea level (COR = 0.802). In fully adjusted analyses, obesity (adjusted odds ratio [AOR] =3.080), chronic kidney disease (AOR = 3.629), and the use of corticosteroid (AOR = 0.470) were also significantly associated with CTS. CONCLUSION Similar to the findings of other studies, this study identified several potential risk factors for CTS. More large-scale longitudinal studies are required to establish a precise causal association.
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Affiliation(s)
- Yaser A. Alendijani
- Department of Family Medicine and Polyclinic, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Bahaa A. Abaalkhail
- Department of Family and Community Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
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Sugiura K, Omura T, Miyagi M, Shibata Y, Matsuyama Y. Prevalence and the Influence of Trapeziometacarpal Osteoarthritis on Patients with Carpal Tunnel Syndrome. J Hand Surg Asian Pac Vol 2023; 28:96-101. [PMID: 36803330 DOI: 10.1142/s2424835523500029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
Background: The coexistence of carpal tunnel syndrome (CTS) and trapeziometacarpal (TMC) osteoarthritis have been previously described. The influence of TMC osteoarthritis in the outcomes of CTS surgery is yet to be elucidated. The purpose of this study is to examine the prevalence of TMC osteoarthritis in patients who underwent open carpal tunnel release (OCTR) and to analyse the influence of osteoarthritis on the postoperative outcomes of CTS. Methods: We retrospectively reviewed 134 procedures on 113 patients who underwent OCTR between 2002 and 2017. The presence of TMC osteoarthritis was based upon preoperative plain radiograph. For the evaluation of CTS, pre- and postoperative muscle power of abductor pollicis brevis (APB) muscle by manual muscle testing (MMT) and distal motor latency (DML) detected on the APB muscle was examined. Results: The mean follow-up period was 11.4 months. The prevalence of radiographic TMC osteoarthritis was 40% in patients who underwent OCTR. In electrophysiological study, the mean pre- and postoperative DML showed no statistical difference regardless of the coexistence of TMC osteoarthritis. However, there was a significantly higher incidence of poorer muscle strength of the APB in patients with TMC osteoarthritis. No patients complained of TMC joint pain prior to OCTR, but four cases developed TMC joint pain during the postoperative follow-up period, all of whom had full recovery of APB muscle strength. Conclusions: The presence of asymptomatic TMC osteoarthritis may affect the postoperative outcomes of OCTR, so preoperative evaluation of TMC osteoarthritis should be considered in patients undergoing OCTR. In addition, the symptoms of TMC osteoarthritis may worsen in some patients after CTS surgery and should be taken into consideration during the postoperative follow-up. Level of Evidence: Level IV (Therapeutic).
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Affiliation(s)
- Kaori Sugiura
- Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Takao Omura
- Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Michihito Miyagi
- Department of Orthopaedic Surgery, Shizuoka Cancer Center, Nagaizumi, Japan
| | - Yosuke Shibata
- Department of Community Health and Preventative Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Yukihiro Matsuyama
- Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
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Umay E, Gurcay E, Serce A, Gundogdu I, Uz C. Is superficial radial nerve affected in patients with hand osteoarthritis? J Hand Ther 2022; 35:461-467. [PMID: 33832810 DOI: 10.1016/j.jht.2021.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 12/09/2020] [Accepted: 01/07/2021] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Patients with superficial radial neuropathy (SRN) have pain and abnormal sensation on the hand similar to hand osteoarthritis (HOA). PURPOSE OF THE STUDY The aim of the present study was to evaluate the presence of SRN in patients with HOA and to determine the factors associated with electrophysiological parameters of the radial nerve. STUDY DESIGN This is a case-control study. METHODS A total of 138 patients were included in this study. Only the dominant hand of each patient was evaluated. Patients were divided into 2 groups: Group 1 (without SRN) or Group 2 (with SRN) by electrophysiological examination. The presence of osteoarthritis in the first carpometacarpal (1st CMC) joint was investigated. Radiological features of the hands were evaluated with Kellgren-Lawrence grading system. Sonographically, the presence of synovitis in the 1st CMC joint was examined with gray scale and synovial blood flow signal by power Doppler imaging. Erosion and osteophyte scoring were performed for 15 joints. The 1st extensor compartment of wrist's cross-sectional area was measured. RESULTS SRN was detected in 68.8% of the patients. High Kellgren-Lawrence scores (P = .027), presence of synovitis in the 1st CMC joint (P = .003), and increased cross-sectional area of the 1st extensor compartment of wrist (P = .005) were found to be independent risk factors for reduced superficial radial nerve conduction velocity. CONCLUSIONS Sensory symptoms in patients with HOA might be due to the involvement of the superficial branch of the radial nerve.
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Affiliation(s)
- Ebru Umay
- Department of Physical Medicine and Rehabilitation, Ankara Dışkapı Yıdırım Beyazıt Training and Research Hospital, University of Health Sciences Turkey, Ankara, Turkey.
| | - Eda Gurcay
- Department of Physical Medicine and Rehabilitation, Gaziler Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Azize Serce
- Department of Physical Medicine and Rehabilitation, Ankara Dışkapı Yıdırım Beyazıt Training and Research Hospital, University of Health Sciences Turkey, Ankara, Turkey
| | - Ibrahim Gundogdu
- Department of Physical Medicine and Rehabilitation, Ankara Dışkapı Yıdırım Beyazıt Training and Research Hospital, University of Health Sciences Turkey, Ankara, Turkey
| | - Cuma Uz
- Department of Physical Medicine and Rehabilitation, Ankara Dışkapı Yıdırım Beyazıt Training and Research Hospital, University of Health Sciences Turkey, Ankara, Turkey
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Djossou HJ, Tuffet S, Rousseau A, Latourte A, Laredo JD, Berenbaum F, Sellam J. Impact of carpal tunnel syndrome on symptoms and structural severity of hand osteoarthritis: results from the DIGICOD cohort. Clin Rheumatol 2022; 41:947-950. [DOI: 10.1007/s10067-021-06042-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 12/20/2021] [Accepted: 12/24/2021] [Indexed: 11/29/2022]
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YAĞIZ ON A. Romatolojik hastalıklarda tuzak nöropatileri: Epidemiyoloji, tanı ve ayırıcı tanı. EGE TIP DERGISI 2021. [DOI: 10.19161/etd.863703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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López-López CO, Montes Castillo MDLL, Soto-Fajardo RC, Sandoval-García LF, Loyola-Sánchez A, Burgos-Vargas R, Peláez-Ballestas I, Álvarez Hernández E, Vázquez-Mellado J. Peripheral neuropathies in rheumatic diseases: More diverse and frequent than expected. A cross-sectional study. Int J Rheum Dis 2019; 23:226-232. [PMID: 31762210 DOI: 10.1111/1756-185x.13755] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 10/29/2019] [Accepted: 11/04/2019] [Indexed: 12/24/2022]
Abstract
BACKGROUND/OBJECTIVE Peripheral neuropathies (PN) are heterogeneous nerve disorders; frequently rheumatic patients have neuropathic symptoms. In some rheumatic diseases (RD) PN are secondary to nerve compression while others are related to metabolic abnormalities, inflammation or vasculitis. Our aim was to explore the frequency of neuropathic symptoms with three neuropathy questionnaires (NQ) and nerve conduction studies (NCS) in RD. METHODS This is a cross-sectional study in patients with any RD attending for the first time to a rheumatology outpatient clinic. We included all patients who accepted to participate and who answered three NQ and received a physical evaluation. Twenty patients were randomly selected to perform NCS and 10 healthy subjects were included as controls. The topographic diagnoses were: mononeuropathy, multiplex mononeuropathy, and/or polyneuropathy. STATISTICAL ANALYSIS descriptive statistics (mean, median, standard deviation, interquartile range and frequency, odds ratios and Pearson correlation test). RESULTS One hundred patients and 10 healthy subjects were included. Sixty-nine were female, mean age 40.6 ± 15.7 years. Rheumatic diagnoses were: systemic lupus erythematosus (26%), rheumatoid arthritis (16%), gout (14%), and osteoarthritis (11%). Fifty-two patients had neuropathic signs during physical examination and 67% had positive questionnaires with variable scores among several RD. Abnormal NCS was reported in 14 patients (70%): 6 (42.8%) median nerve mononeuropathies, 4 (28.5%) multiplex mononeuropathies and 4 (28.5%) polyneuropathies. None of the healthy subjects had neuropathy (NQ, physical evaluation, or NCS). Risk of being NCS positive is higher when the patients were NQ positive. CONCLUSION PN has variable distribution and high frequency in patients with RD; NQ+ increases the risk of presenting NCS+ for PN.
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