目的:使用手部骨关节炎(HOA)的临床检查和超声(US)来表征腱鞘炎和肌腱损伤对疼痛和手功能的频率和影响。
方法:我们纳入了86例HOA患者和23例年龄和性别匹配的对照受试者。通过临床检查和超声检查评估双手的伸肌和屈肌肌腱是否有腱鞘炎。肌腱损伤。获得了常规的X射线照片。通过M-SACRAH问卷的功能子测试和Moberg拾取测试来评估手功能。计算K均值聚类分析,以根据影像学特征和超声肌腱评分评估聚类。
结果:超声发现60/86(69.8%)HOA患者中≥1条肌腱受累,而对照组为2/23(8.7%)(p<0.01)。在HOA组,与伸肌腱相比,美国在屈肌腱中检测到的肌腱损伤更常见(2.1%0.9%,p=0.03),而与屈肌肌腱相比,在伸肌肌腱中更经常观察到腱鞘炎(8%vs0.6%,p<0001)。临床检查发现肌腱受累的敏感性和特异性分别为81.4%和34.6%,在患者水平上分别为14.5%和83.8%。聚类分析显示,一个簇具有更多的HOA影像学特征和更多的肌腱损伤,而在第2组中发现了更多的腱鞘炎。M-SACRAH功能与US的肌腱受累无关。
结论:这项研究显示,在HOA中,肌腱受累的频率很高。肌腱受累不会影响手功能或自我报告的疼痛。
OBJECTIVE: To characterise the frequency and influence of
tenosynovitis and tendon damage on pain and hand function using clinical examination and ultrasound (US) in hand osteoarthritis (HOA).
METHODS: We included 86 patients with HOA and 23 age- and sex-matched control subjects. Extensor and flexor tendons of both hands were assessed by clinical examination and US for
tenosynovitis, tendon damage. Conventional radiographs were acquired. Hand function was evaluated by the function subtest of the M-SACRAH questionnaire and the Moberg pick-up test. K-means cluster analyses was calculated to assess clusters based on radiographic features and sonographic tendon scores.
RESULTS: Ultrasound identified the involvement of ≥ 1 tendon in 60/86 (69.8%) HOA patients compared with 2/23 (8.7%) subjects (p< 0.01) in the control group. In the HOA group, US detected tendon damage more often in flexor tendons compared with extensor tendons (2.1% 0.9%, p= 0.03), while
tenosynovitis was observed more often in extensor tendons compared with flexor tendons (8% vs 0.6%, p< 0001). The sensitivity and specificity of clinical examination to detect tendon involvement was 81.4% and 34.6%, respectively on the patient level and 14.5% and 83.8% on the tendon level. The cluster analyses revealed one cluster with more radiographic features of HOA and more tendon damage while more
tenosynovitis was found in cluster 2. M-SACRAH function did not correlate with tendon involvement on US.
CONCLUSIONS: This study revealed a high frequency of tendon involvement in HOA. Tendon involvement on US did not impact hand function or self-reported pain.