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The relation between synovitis of individual finger joints and grip force over the first 5 years in early rheumatoid arthritis — a cohort study

Rydholm, Maria ; Sharma, Ankita LU ; Jacobsson, Lennart LU and Turesson, Carl LU (2023) In Arthritis Research and Therapy 25(1).
Abstract

Objective: The objective of this study was to investigate the relation between swelling and tenderness of individual finger joints and grip force in patients with early rheumatoid arthritis (RA). Methods: In an inception cohort of patients with early RA (symptom duration < 12 months), all patients were examined by the same rheumatologist, and grip force was measured using the Grippit instrument at inclusion, 1 and 5 years. The average grip force values of each hand were evaluated and expressed as % of expected values, based on age- and sex-specific reference values. Linear regression analyses were used to assess the cross-sectional relation between the involvement of individual finger joints and grip force. In generalized estimating... (More)

Objective: The objective of this study was to investigate the relation between swelling and tenderness of individual finger joints and grip force in patients with early rheumatoid arthritis (RA). Methods: In an inception cohort of patients with early RA (symptom duration < 12 months), all patients were examined by the same rheumatologist, and grip force was measured using the Grippit instrument at inclusion, 1 and 5 years. The average grip force values of each hand were evaluated and expressed as % of expected values, based on age- and sex-specific reference values. Linear regression analyses were used to assess the cross-sectional relation between the involvement of individual finger joints and grip force. In generalized estimating equations, the impact of time-varying synovitis/tenderness on grip force over time was estimated. Analyses were adjusted for wrist involvement, erythrocyte sedimentation rate, and patient-reported pain. Results: In 215 patients with early RA, grip force was 39% of expected at diagnosis, and increased to 56% after 5 years. Synovitis of the first metacarpophalangeal (MCP) joint (60% and 69% at baseline in the right and left hand) was associated with reduced grip force at inclusion (adjusted ß − 9.2 percentage unit of expected grip force; 95% CI − 13.6 to − 4.8 for both hands combined) and at all follow-up evaluations. Synovitis of MCP I and MCP IV (12% at baseline) was significantly associated with reduced grip force over time in both hands. Proximal interphalangeal (PIP) joint swelling, and tenderness of MCP or PIP joints, had less impact on grip force. Conclusion: MCP I synovitis is the major contributor to reduced grip force in patients with early RA. This underlines the importance of the involvement of the thumb for impaired hand function in RA. MCP IV synovitis, but not PIP involvement or finger joint tenderness, also has a substantial impact on grip force.

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Finger joints, Hand strength, Rheumatoid arthritis, Synovitis
in
Arthritis Research and Therapy
volume
25
issue
1
article number
231
publisher
BioMed Central (BMC)
external identifiers
  • pmid:38037132
  • scopus:85178172796
ISSN
1478-6354
DOI
10.1186/s13075-023-03212-6
language
English
LU publication?
yes
additional info
Funding Information: Open access funding provided by Lund University. This study was supported by the Swedish Research Council, The Swedish Rheumatism Association, Region Skåne, and Lund University. Publisher Copyright: © 2023, The Author(s).
id
8cd9b47d-c4d7-47af-9224-adbdbf26de08
date added to LUP
2023-12-21 12:31:08
date last changed
2024-04-19 21:59:58
@article{8cd9b47d-c4d7-47af-9224-adbdbf26de08,
  abstract     = {{<p>Objective: The objective of this study was to investigate the relation between swelling and tenderness of individual finger joints and grip force in patients with early rheumatoid arthritis (RA). Methods: In an inception cohort of patients with early RA (symptom duration &lt; 12 months), all patients were examined by the same rheumatologist, and grip force was measured using the Grippit instrument at inclusion, 1 and 5 years. The average grip force values of each hand were evaluated and expressed as % of expected values, based on age- and sex-specific reference values. Linear regression analyses were used to assess the cross-sectional relation between the involvement of individual finger joints and grip force. In generalized estimating equations, the impact of time-varying synovitis/tenderness on grip force over time was estimated. Analyses were adjusted for wrist involvement, erythrocyte sedimentation rate, and patient-reported pain. Results: In 215 patients with early RA, grip force was 39% of expected at diagnosis, and increased to 56% after 5 years. Synovitis of the first metacarpophalangeal (MCP) joint (60% and 69% at baseline in the right and left hand) was associated with reduced grip force at inclusion (adjusted ß − 9.2 percentage unit of expected grip force; 95% CI − 13.6 to − 4.8 for both hands combined) and at all follow-up evaluations. Synovitis of MCP I and MCP IV (12% at baseline) was significantly associated with reduced grip force over time in both hands. Proximal interphalangeal (PIP) joint swelling, and tenderness of MCP or PIP joints, had less impact on grip force. Conclusion: MCP I synovitis is the major contributor to reduced grip force in patients with early RA. This underlines the importance of the involvement of the thumb for impaired hand function in RA. MCP IV synovitis, but not PIP involvement or finger joint tenderness, also has a substantial impact on grip force.</p>}},
  author       = {{Rydholm, Maria and Sharma, Ankita and Jacobsson, Lennart and Turesson, Carl}},
  issn         = {{1478-6354}},
  keywords     = {{Finger joints; Hand strength; Rheumatoid arthritis; Synovitis}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{Arthritis Research and Therapy}},
  title        = {{The relation between synovitis of individual finger joints and grip force over the first 5 years in early rheumatoid arthritis — a cohort study}},
  url          = {{http://dx.doi.org/10.1186/s13075-023-03212-6}},
  doi          = {{10.1186/s13075-023-03212-6}},
  volume       = {{25}},
  year         = {{2023}},
}