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[The distribution of destructive polyarthritic changes in the hand skeleton]
Zeitschrift Fur Rheumatologie
|July 1, 1978
Summary
Advanced polyarthrosis commonly causes symmetrical erosive changes in finger joints, particularly the distal and proximal interphalangeal joints, sparing the thumb. This study highlights key diagnostic considerations for differentiating these arthritic conditions.
Area of Science:
- Rheumatology
- Radiology
- Orthopedics
Background:
- Polyarthrosis, a common joint disease, presents with varied erosive and degenerative changes.
- Radiological assessment is crucial for understanding the distribution and pattern of joint involvement.
Purpose of the Study:
- To radiologically demonstrate the distribution of erosive and degenerative changes in advanced polyarthrosis of the hands.
- To differentiate polyarthrosis from other inflammatory arthropathies like rheumatoid arthritis, psoriatic arthritis, and gout.
Main Methods:
- Radiological examination of the hands in 32 patients with advanced polyarthrosis.
- Analysis of the distribution and symmetry of erosive destructions in various finger joints.
Main Results:
- 23 out of 32 patients exhibited erosive destructions in at least one joint.
- Alterations were generally symmetrical, predominantly affecting the distal interphalangeal (DIP) and proximal interphalangeal (PIP) joints (DIP II, III, V; PIP III).
- The thumb joints were typically spared from erosive changes.
Conclusions:
- Advanced polyarthrosis frequently involves symmetrical erosive changes in the small finger joints, with characteristic patterns of involvement.
- Understanding these patterns aids in differential diagnosis, particularly distinguishing from rheumatoid arthritis, psoriatic arthritis, and gout.
- Mechanical factors may play a significant role in the pathogenesis of primary osteoarthritis in the small finger joints.