Hand involvement in Behçet's disease

To study the clinical hand findings in Behçet's disease (BD) and to observe scintigraphic changes of these areas.

Fifty-seven randomly selected BD patients and the patients in the control group (N=40) were evaluated by two blind rheumatologists. The hands were examined for the presence of pain, tenderness, swelling, effusion, erythema, warmth, range of motion and limitation of motion, deformities and muscle atrophy. Then scintigraphic examination of the hands was performed. Control hand scintigrams were obtained from 40 age- and sex-matched patients and were examined by the same two observers.

Thirty-two of the 57 patients (56.1%) showed Behçet's clinical hand findings. Terminal phalangeal pulp atrophy was observed in 17 (29.81%), rheumatoid-like hand findings were observed in 16 (28.1%), dorsal interosseos atrophy was observed in 12 (20.05%) and erythema over the digits was observed in 12 (20.05%). Twenty-four patients (42.1%) had scintigraphic involvement. The disease duration was observed to be an important factor for hand findings (P=0.040) and scintigraphic involvement (P=0.011).

High prevalence of hand involvement in BD and its relationship with disease duration is demonstrated. Hand involvement tends to be overlooked and careful examination is required in the evaluation of BD. The scintigraphic involvement detected in hands requires special consideration, too.