Spontaneous ankylosis in erosive osteoarthritis of the finger joints: a case series of eight postmenopausal women
Tóm tắt
Osteoarthritis of the hands is very common, particularly in elderly people. Little is known though, is the subset of erosive osteoarthritis (EOA), which predicts a poorer prognosis and causes much more discomfort. Even less known is the fact that this subset can evolve into spontaneous ankylosis. We describe eight women (average age 62.6, range 54–74 years) with EOA and spontaneous ankylosis of the proximal interphalangeal (PIP) and/or distal interphalangeal (DIP) joints. In total, 21 PIP joints (0–7 per patient) were found with EOA and nine PIP joints (0–3 per patient) with ankylosis. In one patient, ankylosis of the PIP was already seen at the first presentation. In the other cases, it took an average of 77.4 months (range 34–119) for EOA to develop into ankylosis of the PIP. For DIP joints, the numbers were 17 joints (1–4 per patient) with EOA and three joints (0–1 per patient) with ankylosis, respectively. In one patient, ankylosis of the DIP was already seen at the first presentation. Ankylosis was found significantly more often on the left hand (n = 10) compared to the right hand (n = 2; p < 0.0005), while all the patients were right handed. No difference in handedness was found for the occurrence of EOA. Although rare, PIP or DIP joint with EOA can—over the course of several painful years—develop into a spontaneous pain-free ankylosis. Ankylosis was more commonly found in the left hand than in the right hand, probably due right handedness.
Tài liệu tham khảo
Zang W, Doherty M, Leeb BF et al (2009) Eular evidence-based recommendations for the diagnosis of hand osteoarthritis: report of a task force of the EULAR Standing Committee for International Clinical Studies including Therapeutics. Ann Rheum Dis 68:8–17
Punzi L, Frigato M, Frallonardo P, Ramonda R (2010) Inflammatory osteoarthritis of the hand. Best Practice and Research Clinical Rheumatology 24:301–312
Rovetta G, Bianchi G, Monteforte P (1995) Joint failure in erosive osteoarthritis of the hands. Int J Tiss Reac 17:33–42
Smukler NM, Edeiken J, Giuliano VJ (1971) Ankylosis in osteoarthritis of the fingerjoints. Radiology 100:525–530
Mc EC (1968) Osteoarthritis of the fingers with ankylosis. Arthritis Rheum 11:734–744
Gold RH, Bassett, LW, Seeger LL. The other arthritides. In: Radiological Clinics of North America 1988; 26: 1195-1212
Addimanda O, Mancarella L, Dolzani P, Punzi L, Fioravanti A, Pignotto E et al (2012) Clinical and radiographic distribution of structural damage in erosive and nonerosive osteoarthritis. Arthritis Care Res 7:1046–1053
Kloppenburg M, Kwok WY (2011) Hand osteoarthritis—a heterogenous disorder. Nat Rev Rheumatol 22:22–31
Kwok WY, Kloppenburg M, Rosendaal FR, van Meurs JB, Hofman A, Bierma-Zeinstra SMA (2011) Erosive hand osteoarthritis: its prevalence and clinical impact in the general population and symptomatic hand osteoarthritis. Ann Rheum Dis 70:1238–1242
Verbruggen G, Veys EM (1996) Numerical scoring systems for the anatomic evolution of osteoarthritis of the fingerjoints. Arthritis Rheum 39:308–320
Pattrick M, Aldridge S, Hamilton E, Manhire A, Doherty M (1989) A controlled study of hand function in nodal and erosive osteoarthritis. Ann Rheum Dis 48:978–982