Article

OBJECTIVES: To identify early predictors of stenosing tenosynovitis in the hand
and hand-related activity limitations in patients with rheumatoid arthritis (RA).
DESIGN: A longitudinal study of an inception cohort.
SETTING: A large outpatient
clinic. PARTICIPANTS: Consecutive patients who attended the Early Arthritis
Clinic for at least 2 years and fulfilled the American College of Rheumatology
criteria for RA at baseline and/or at the 1-year follow-up were invited to
participate until 200 patients were included. INTERVENTIONS: Not applicable. MAIN
OUTCOME MEASURES: Stenosing tenosynovitis, assessed by means of a standardized
physical examination. Hand-related activity limitations, assessed with the
Disabilities of Arm, Shoulder and Hand questionnaire (DASH). A DASH score above
the upper limit of the 95% range of the normative score was defined as abnormal.
Prognostic factors: demographic and disease activity-related variables,
radiographic damage, the Health Assessment Questionnaire (HAQ) total score and
category scores at the 2-year follow-up. RESULTS: The mean age +/- SD of the
patients was 59.7+/-10.7 years (75% female). The mean time +/- SD between the
2-year follow-up and the assessment of the dependent variables was 3.9+/-2.7
years. Stenosing tenosynovitis was present in 33%. The median (interquartile
range) DASH score was 26.7 (10.8-42.5); 30% were abnormal. Stenosing
tenosynovitis was predicted by the HAQ subscale regarding the use of hands
(HAQ-hand) at the 2-year follow-up (odds ratio [OR], 2.3; 95% confidence interval
[CI], 1.2-4.2). Hand-related activity limitations were predicted by the Disease
Activity Score in 28 joints (OR, 1.8; 95% CI, 1.3-2.4) and HAQ-hand (OR, 2.4; 95%
CI, 1.3-5.8) at the 2-year follow-up. CONCLUSIONS: Stenosing tenosynovitis in
patients with RA was predicted by HAQ-hand at the 2-year follow-up, and
hand-related activity limitations were predicted by disease activity and HAQ-hand
at the 2-year follow-up.
CI - Copyright (c) 2011 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS