The lateral metacarpophalangeal/metatarsophalangeal squeeze: an alternative assignment criterion for rheumatoid...

We have proposed an alternate assignment criterion for rheumatoid arthritis (RA), pain on squeezing the MCP or MTP joints. The performance of this criterion has been evaluated in 90 patients with RA and in 122 patients with other rheumatological disorders (non-RA). The proportions of patients with various numbers of sites positive (from 0 to 4) were assessed according to diagnosis; most patients with RA had at least one site positive, in comparison to non-RA where most patients had no sites positive. The diagnostic performance of 2+ or 3+ sites was similar, but 3+ is probably preferable because this simultaneously indicated both symmetry and hand and foot involvement. In conclusion, the lateral MCP/MTP squeeze performs well in comparison to many other existing clinical criteria for RA and could substitute for non-independent features (e.g. swelling and arthritis). It is easier to elicit than searching for pain and/or tenderness as fewer sites have to be examined and inter-observer variation was less than with many other clinical criteria.