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Screening for extensor tendon rupture in rheumatoid arthritis.
L Williamson1, A Mowat, P Burge
1Department of Rheumatology, Nuffield Orthopaedic Centre, Oxford OX3 7LD, UK.
Rheumatology (Oxford, England)
|April 20, 2001
Summary
A simple test for extensor digiti minimi (EDM) rupture can identify rheumatoid arthritis patients at risk for tendon damage. This screening may allow for prophylactic surgery before significant loss of hand function occurs.
Area of Science:
- Rheumatology
- Orthopedic Surgery
- Hand Surgery
Background:
- Rheumatoid arthritis (RA) can lead to extensor tendon rupture in the wrist, often affecting the extensor digiti minimi (EDM) tendon first.
- Rupture of the EDM tendon may go unnoticed due to the function of the extensor digitorum communis (EDC) tendon, which extends all four fingers.
- Identifying at-risk patients for prophylactic surgery is crucial to prevent functional loss in RA patients.
Purpose of the Study:
- To evaluate the effectiveness of screening for extensor digiti minimi (EDM) rupture by assessing independent little finger extension in rheumatoid arthritis patients.
- To determine if this simple test can identify individuals at risk for extensor tendon rupture.
Main Methods:
- The extensor digiti minimi (EDM) test was conducted on 550 previously unoperated rheumatoid arthritis wrists.
- Data collected included disease activity, joint damage, wrist swelling, tenderness, and crepitus.
Main Results:
- Unsuspected EDM tendon loss was detected in 1.6% (9 out of 550) of the wrists.
- EDM loss was not significantly associated with disease activity, severity, or duration.
- Minimal or absent dorsal synovitis and absent ulnar tenderness were noted in most cases of EDM loss.
Conclusions:
- The EDM test is a simple, inexpensive method for screening extensor tendon integrity in RA patients.
- This screening can potentially identify patients requiring prophylactic surgery to prevent hand function loss.