Abstract：
Peritrapezial osteoarthritis (OA) includes scaphotrapezial and trapeziometacarpal OA. In clinical practice, scaphotrapezial OA seems better tolerated than trapeziometacarpal OA, with fewer complaints and better tolerance. The difference in pain could be linked to a difference in joint capsule innervation, perhaps with fewer nerve fibers in the scaphotrapezial than the trapeziometacarpal joint.
We performed a histologic evaluation of these two joints to compare their respective innervation in 17 cadaveric specimens with peritrapezial OA. Radiographic scoring confirmed the presence of peritrapezial OA. Mean Kellgren-Lawrence score was 2.2 ± 1.1 in the trapeziometacarpal joint and 1.5 ± 0.7 in the scaphotrapezial joint (p = 0.08).
There was no difference between scaphotrapezial and trapeziometacarpal joints in number of neurofilaments: 5.2 ± 3.9 and 4.4 ± 4.5, respectively (p = 0.20). A significant difference was found in S100 staining (myelinated structures), with a higher rate in the scaphotrapezial joint: 11.8 ± 7.5 vs 6.6 ± 5.2 (p = 0.005).
The present study suggests that lower tolerance of trapeziometacarpal OA is not due to a difference in joint capsule innervation. On the contrary, we found a higher rate of myelinated tissues in the scaphotrapezial joint. These results suggested other pain pathways to explain clinical observations.
We performed a histologic evaluation of these two joints to compare their respective innervation in 17 cadaveric specimens with peritrapezial OA. Radiographic scoring confirmed the presence of peritrapezial OA. Mean Kellgren-Lawrence score was 2.2 ± 1.1 in the trapeziometacarpal joint and 1.5 ± 0.7 in the scaphotrapezial joint (p = 0.08).
There was no difference between scaphotrapezial and trapeziometacarpal joints in number of neurofilaments: 5.2 ± 3.9 and 4.4 ± 4.5, respectively (p = 0.20). A significant difference was found in S100 staining (myelinated structures), with a higher rate in the scaphotrapezial joint: 11.8 ± 7.5 vs 6.6 ± 5.2 (p = 0.005).
The present study suggests that lower tolerance of trapeziometacarpal OA is not due to a difference in joint capsule innervation. On the contrary, we found a higher rate of myelinated tissues in the scaphotrapezial joint. These results suggested other pain pathways to explain clinical observations.
摘要：
目的：室间隔性骨关节炎（OA）包括肩胛骨和梯形掌骨OA。在临床实践中,肩胛骨OA似乎比梯形掌骨OA耐受性更好，更少的抱怨和更好的宽容。疼痛的差异可能与关节囊神经支配的差异有关，肩胛骨的神经纤维可能少于梯形掌关节。
方法：我们对这两个关节进行了组织学评估，以比较其在17例尸体标本中的神经支配。X线照相评分证实了周围性OA的存在。平均Kellgren-Lawrence评分在梯形掌骨关节为2.2±1.1，在肩胛骨关节为1.5±0.7（p=0.08）。
结果：肩脑和梯形掌骨之间的神经丝数量没有差异：分别为5.2±3.9和4.4±4.5（p=0.20）。在S100染色（有髓鞘结构）中发现了显着差异，肩胛骨关节的比率较高：11.8±7.5vs6.6±5.2（p=0.005）。
结论：本研究表明，梯形掌骨OA的耐受性较低不是由于关节囊神经支配的差异。相反,我们发现肩胛骨关节有髓鞘组织的比率较高。这些结果提示了其他疼痛途径来解释临床观察。
方法：我们对这两个关节进行了组织学评估，以比较其在17例尸体标本中的神经支配。X线照相评分证实了周围性OA的存在。平均Kellgren-Lawrence评分在梯形掌骨关节为2.2±1.1，在肩胛骨关节为1.5±0.7（p=0.08）。
结果：肩脑和梯形掌骨之间的神经丝数量没有差异：分别为5.2±3.9和4.4±4.5（p=0.20）。在S100染色（有髓鞘结构）中发现了显着差异，肩胛骨关节的比率较高：11.8±7.5vs6.6±5.2（p=0.005）。
结论：本研究表明，梯形掌骨OA的耐受性较低不是由于关节囊神经支配的差异。相反,我们发现肩胛骨关节有髓鞘组织的比率较高。这些结果提示了其他疼痛途径来解释临床观察。
