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Carpal collapse in rheumatoid arthritis--prevalence and clinical significance: a preliminary study
1Department of Rheumatology, Hospital de Especialidades Centro Medico Nacional León Guanajuato, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
Objective:
To evaluate the prevalence and clinical significance of carpal collapse in Mexican women with rheumatoid arthritis (RA).
Methods:
We evaluated the carpal height ratio (CHR) of 97 women with RA and 90 healthy women. Using plain radiographs of both hands, measurements were performed by 2 radiologists in a single blind fashion. We analyzed functional class, characteristics and duration of the disease, and presence of rheumatoid factor (RF).
Results:
CHR values of the controls were 0.49+/-0.02 (values reported in American Caucasian women are 0.54+/-0.04). Thirty-five patients had carpal collapse (defined as CHR < or = 0.43) in the right hand, 30 in the left hand, and 23 bilaterally. Carpal collapse was associated with RF seropositivity and roentgenographic degree of progression (p < 0.01), as well as with cumulative dose of steroids. As 95% of the patients were right-handed, dexterity was not apparently affected. We observed no differences in Health Assessment Questionnaire, functional class, or disease duration between patients with and those without carpal collapse.
Conclusion:
The definition of carpal collapse may have ethnic related differences. Carpal collapse is common in Mexican women with RA and it is not an indicator of functional limitations.