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Wrist involvement in Hansen's disease
P Carpintero1, A García-Frasquet, P Pradilla
1University of Cordoba, Spain.
The Journal of Bone and Joint Surgery. British Volume
|October 23, 1997
Summary
Neurological and radiological wrist changes in Hansen's disease patients suggest neuropathic arthropathy. Sensory impairment correlated with significant carpal and radiocarpal joint alterations, distinct from motor deficits.
Area of Science:
- Neurology
- Radiology
- Rheumatology
- Orthopedics
Background:
- Hansen's disease (leprosy) can cause neurological deficits affecting various body parts.
- Neuropathic arthropathy, joint damage due to nerve dysfunction, is well-documented in weight-bearing joints.
- Limited research exists on neuropathic arthropathy in non-weight-bearing joints like the wrist.
Purpose of the Study:
- To investigate neurological and radiological wrist abnormalities in patients with Hansen's disease.
- To compare wrist parameters between Hansen's disease patients and healthy controls.
- To explore the relationship between neurological impairment severity and wrist structural changes.
Main Methods:
- Neurological and radiological assessments of wrists were conducted.
- Study included 58 patients with Hansen's disease and 60 age-matched healthy controls.
- Patients were categorized into subgroups based on sensory impairment, motor deficit, or no neurological impairment.
Main Results:
- Significant differences (p < 0.01) were observed in carpal glenoid sector, radial physeal widening index, carpal ulnar distance, carpal index, and distal radio-ulnar discrepancy between patients and controls.
- Patients with sensory impairment showed significant differences (p < 0.01) in wrist parameters compared to those with motor deficit or no neurological impairment.
- These findings indicate distinct radiological changes in the carpus and radiocarpal joint associated with sensory neuropathy.
Conclusions:
- Wrist structural changes in Hansen's disease patients are likely due to neuropathic arthropathy.
- Sensory impairment plays a crucial role in the development of these wrist alterations.
- This study highlights the occurrence of neuropathic arthropathy in a non-weight-bearing joint, expanding understanding of leprosy's musculoskeletal impact.