Nonarticular Tenderness and Functional Status in Patients with Diffuse Idiopathic Skeletal Hyperostosis

Journal of Rheumatology - Tập 37 Số 9 - Trang 1911-1916 - 2010
Reuven Mader1, Irina Novofastovski, Ehud Rosner, Muhammad Adawi, Paula Herer, Dan Buskila
1Rheumatic Diseases Unit, Ha'Emek Medical Center, Afula 18101, Israel. [email protected]

Tóm tắt

Objective.To investigate the degree of nonarticular tenderness and functional status in patients with diffuse idiopathic skeletal hyperostosis (DISH). We assessed these variables’ correlation with their clinical, radiographic, and constitutional measurements and with metabolic syndrome (MS).Methods.Eighty-seven patients with DISH were compared with 65 controls without DISH. Examination of nonarticular tenderness was performed by thumb palpation. Tenderness was scored for the 18 fibromyalgia tender points (TP), and 4 control points. Nonarticular tenderness was expressed by the number of TP and by the total tenderness score (TTS). The Short Health Assessment Questionnaire (HAQ II) was administered to all participants. Clinical and laboratory data were collected from all patients. Patients were classified as having MS by both the National Cholesterol Education Program and World Health Organization definitions.Results.There was a statistically significant difference in TTS between controls and patients with DISH. The mean tenderness of many individual TP was significantly higher in the DISH group compared with the control group. TP counts, TTS, and body mass index (BMI) positively correlated with the HAQ II. There was a linear trend in intensity of T-spine bony bridges (BB) and the total number of TP as well as many individual TP. Patients with DISH were more likely to be affected by MS. No correlation was found between TP count, TTS, and MS.Conclusion.Patients with DISH have a lower pain threshold than patients who do not have DISH. TP count and TTS correlate with the functional status, BMI, waist circumference, and high-grade BB. No correlation was observed between pain threshold and MS.

Từ khóa


Tài liệu tham khảo

10.1148/119.3.559

10.1001/archinte.1976.03630070011006

Mader, 2003, Diffuse idiopathic skeletal hyperostosis: a distinct clinical entity, Isr Med Assoc J, 5, 506

10.1097/00005792-199703000-00003

10.1016/j.semarthrit.2008.01.010

10.1016/j.metabol.2006.09.001

Resnick D Niwayama G . Diagnosis of bone and joint disorders. 2nd ed. Philadelphia: WB Saunders; 1988:1563–615.

10.1002/art.1780330203

10.1002/art.20549

10.1001/jama.285.19.2486

10.1093/aje/kwf145

10.1161/01.CIR.0000138740.84883.9C

10.1093/rheumatology/28.4.277

10.1093/rheumatology/29.5.349

10.1093/rheumatology/31.5.319

10.1002/art.1780230202

Fries, 1982, The dimensions of health outcomes: the Health Assessment Questionnaire, disability and pain scales, J Rheumatol, 9, 789

10.1002/art.11024

Wolfe, 1998, The long-term outcomes of rheumatoid arthritis: work disability: a prospective 18 year study of 823 patients, J Rheumatol, 25, 2108

10.1002/1529-0131(199806)41:6<1072::AID-ART14>3.0.CO;2-G

10.1002/art.11439

10.1007/s10067-008-0966-1

10.1016/j.jpain.2008.01.339

10.1002/art.10973

10.1093/rheumatology/ken424

10.1080/030097402317255336

10.1136/ard.9.4.321