Effect of rheumatoid arthritis on strength, dexterity, coordination and functional status of the hand: the relationship with magnetic resonance imaging findings.

Objective: To evaluate the effect of rheumatoid arthritis (RA) on strength, dexterity, coordination and functional status of the hand and to determine the relation with magnetic resonance imaging (MRI) findings.

Materials And Methods: Thirty eight patients with RA and thirty three controls were included in the study. There were five drop-outs in RA group. Pain was assessed by visual analog scale. Painful and swollen joints of the dominant hand were recorded. Hand deformities of the patients were noted. Hand grip strength and pinch strength of the dominant hand were evaluated. Hand disability was assessed by Duruoz hand index (DHI) and the Purdue pegboard test was used for assessment of coordination and dexterity. MRI of the dominant wrist and hand was performed in RA group. MRI scans were evaluated for synovitis, tenosynovitis, bone erosion and bone edema.

Results: Demographic characteristics were similar between groups. While DHI scores were significantly higher (p=0.000), Purdue pegboard test scores were significantly lower in RA group in comparison to control group (p=0.000). Bone edema and synovitis scores were significantly higher in patients with longer disease duration (p=0.025, p=0,006 respectively). There were significant negative correlation between grip strength, pinch strength subgroups and tenosynovitis scores (p=0.001, p=0,001). When the Purdue pegboard scores were lower, tenosynovitis scores were significantly higher (p=0.019, p=0,013, p=0,043). There was a significant positive correlation between DHI score and tenosynovitis score (p=0.003).

Conclusion: This study showed that RA has significant negative impact on hand function and dexterity and the parameters used in the evaluation of hand function are mainly associated with tenosynovitis scores. Since tenosynovitis is a common pathology in RA, MRI can be used as a supportive method in early diagnosis of tenosynovitis and may be useful in identification of patients requiring aggressive treatment.