Erol, A M Şevket Yılmaz Eğitim ve Araştırma Hastanesi - Fiziksel Tıp ve Rehabilitasyon Kliniği, Türkiye , Ceceli, E Ankara Eğitim ve Araştırma Hastanesi - Fiziksel Tıp ve Rehabilitasyon Kliniği, Türkiye , Uysal Ramadan, S 3Keçiören Eğitim ve Araştırma Hastanesi - Radyoloji Kliniği, Türkiye , Borman, P Ankara Eğitim ve Araştırma Hastanesi - Fiziksel Tıp ve Rehabilitasyon Kliniği, Türkiye

Sensory examination of rheumatoid hand and the relationship with magnetic resonance imaging findings

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Aim: The aim of this study was to evaluate the effect of rheumatoid arthritis (RA) on the sensory status of the hand and to determine the relationship with magnetic resonance imaging (MRI) findings. Materials and Methods: Thirty-three RA patients and controls were included in the study. Pain, hot-cold, touch, position, vibration and two point discrimination senses were evaluated in both groups. An MRI of the dominant hand was obtained in the RA group. Synovitis, tenosynovitis, bone erosion and edema were evaluated according to the OMERACT RA-MRI scoring system. Results: Pain, hot-cold, touch and position senses were normal in the RA group. Although vibration was correctly localised by all patients, 60.6% defined a decrease in intensity of vibration. Two point discrimination values were significantly higher in the RA group (p 0.001). Tenosynovitis and synovitis scores were higher in patients who described a decrease in the intensity of vibration (respectively p 0.001, p 0.05). There was a positive correlation between the two point discrimination values at the dorsal phalanx, dorsum of hand, thenar and distal palmar regions and tenosynovitis scores (p 0.05).Conclusion: In our study vibration and two point discrimination were impaired in the RA group. This can be related to nervous system involvement which can be seen in RA as an extra-articular symptom. Additionally proinflammatory cytokines which are produced by tenosynovium can affect mechanoreceptors located in the myotendinous junction leading to sensory disturbances. Hence, a detailed neurological examination is very important in RA. Furthermore, since tenosynovitis is a common pathology in RA, an MRI can be used as a supportive method in diagnosis, treatment and follow up.

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Magnetic resonance imaging , rheumatoid arthritis , sensation , tenosynovitis

Ege Journal Of Medicine

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