Highlights
- •Patients with SRN neuropathy have pain and abnormal sensation on the hand similar to hand OA.
- •Pain and sensory symptoms in patients with hand OA may be due to the SRN.
- •Radiological involvement, synovitis, and 1st extensor compartment of wrist's CSA are independent risk factors for SRN neuropathy.
Abstract
Introduction
Patients with superficial radial neuropathy (SRN) have pain and abnormal sensation
on the hand similar to hand osteoarthritis (HOA).
Purpose of the Study
The aim of the present study was to evaluate the presence of SRN in patients with
HOA and to determine the factors associated with electrophysiological parameters of
the radial nerve.
Study Design
This is a case–control study.
Methods
A total of 138 patients were included in this study. Only the dominant hand of each
patient was evaluated. Patients were divided into 2 groups: Group 1 (without SRN)
or Group 2 (with SRN) by electrophysiological examination. The presence of osteoarthritis
in the first carpometacarpal (1st CMC) joint was investigated. Radiological features
of the hands were evaluated with Kellgren–Lawrence grading system. Sonographically,
the presence of synovitis in the 1st CMC joint was examined with gray scale and synovial
blood flow signal by power Doppler imaging. Erosion and osteophyte scoring were performed
for 15 joints. The 1st extensor compartment of wrist's cross-sectional area was measured.
Results
SRN was detected in 68.8% of the patients. High Kellgren–Lawrence scores (P = .027), presence of synovitis in the 1st CMC joint (P = .003), and increased cross-sectional area of the 1st extensor compartment of wrist
(P = .005) were found to be independent risk factors for reduced superficial radial
nerve conduction velocity.
Conclusions
Sensory symptoms in patients with HOA might be due to the involvement of the superficial
branch of the radial nerve.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Hand TherapyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Prevalence, incidence and progression of hand osteoarthritis in the general population: the Framingham Osteoarthritis Study [published correction appears in Ann Rheum Dis. 2018 Oct;77(10):1546].Ann Rheum Dis. 2011; 70: 1581-1586
- Lifetime risk of symptomatic hand osteoarthritis: the Johnston County Osteoarthritis Project.Arthritis Rheumatol. 2017; 69: 1204-1212
- Assessing health-related quality of life in hand osteoarthritis: a literature review.Ann Rheum Dis. 2011; 70: 921-928
- Joint protection and hand exercises for hand osteoarthritis: an economic evaluation comparing methods for the analysis of factorial trials.Rheumatol Oxf. 2015; 54: 876-883
- Medical services and associated costs vary widely among surgeons treating patients with hand osteoarthritis.Clin Orthop Relat Res. 2015; 473: 1111-1117
- 2018 update of the EULAR recommendations for the management of hand osteoarthritis.Ann Rheum Dis. 2019; 78: 16-24
- American College of Rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee.Arthritis Care Res Hob. 2012; 64: 465-474
- Basal thumb arthritis.Postgrad Med J. 2007; 83: 40-43
- Tenosynovitis of the hand and wrist: a critical analysis review.JBJS Rev. 2016; 4 (01874474-201603000-00001)
- Are carpal tunnel syndrome and regional degenerative osteoarthritis linked? Results of a case-control study.J Hand Surg Asian Pac. 2018; 23: 41-46
- Sensory nerve action potentials and sensory perception in women with arthritis of the hand.J Neuroeng Rehabil. 2012; 9: 27
- Anatomical relations of the superficial sensory branches of the radial nerve: a cadaveric study with clinical implications.Patient Saf Surg. 2011; 5: 28
- Radial nerve mobilization decreases pain sensitivity and improves motor performance in patients with thumb carpometacarpal osteoarthritis: a randomized controlled trial.Arch Phys Med Rehabil. 2012; 93: 396-403
- Effectiveness of superficial radial nerve block on pain, function and quality of life in patients with hand osteoarthritis: a prospective, randomized and controlled single-blind study.Arch Rheumatol. 2018; 33: 464-472
- The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hand.Arthritis Rheum. 1990; 33: 1601-1610
- Oh S. Principles of Clinical Electromyography: Normal Values for Common Nevre Conduction Tests. 2nd ed. Williams and Wilkins Company, Baltimore1998: 84-105
- Radiological assessment of osteo-arthrosis.Ann Rheum Dis. 1957; 16: 494-502
- The ultrasound 7 score in the assessment of synovitis in rheumatoid arthritis: correlation with clinical disease activity indices.Egypt Rheumatol Rehabil. 2017; 44: 103-110
- Ultrasonographic assessment of osteophytes in 127 patients with hand osteoarthritis: exploring reliability and associations with MRI, radiographs and clinical joint findings.Ann Rheum Dis. 2013; 72: 51-56
- Arthritis of the finger joints: a comprehensive approach comparing conventional radiography, scintigraphy, ultrasound, and contrast-enhanced magnetic resonance imaging.Arthritis Rheum. 1999; 42: 1232-1245
- Basic signs of pathology: capsule.in: Dondelinger R.F. Peripheral Musculoskeletal Ultrasound Atlas. George Thieme Verlag, Stuttgart, Germany1996: 39-41
- Statistical Power Analysis for the Behavioral Sciences.2nd ed. Lawrence Erlbaum Associates, Publishers, London1988: 550
- Foundations of Clinical Research: Applications to Practice.3rd ed. FA Davis Company, Philadelphia2015: 525
- Entrapment neuropathies I: upper limb (carpal tunnel excluded).Semin Musculoskelet Radiol. 2010; 14: 473-486
- Pain and hyperalgesia in osteoarthritis of the hands.J Rheumatol. 2000; 27: 441-447
- Increased movement pain in osteoarthritis of the hands is associated with A beta-mediated cutaneous mechanical sensitivity.J Pain. 2000; 1: 229-242
- Peripheral nerve entrapment and neuropathy in the upper extremity.Am Fam Physician. 2010; 81: 147-155
- Grip force control in patients with neck and upper extremity pain and healthy controls.Clin Neurophysiol. 2008; 119: 1840-1848
- Grip force control in individuals with hand osteoarthritis.J Hand Ther. 2011; 24: 345-355
- Ergonomic evaluation of biomechanical hand function.Saf Health Work. 2015; 6: 9-17
- Relationship between hand function and grip force control in women with hand osteoarthritis.J Rehabil Res Dev. 2012; 49: 855-865
- Hand function in female patients with hand osteoarthritis: relation with radiological progression.Hand (N Y). 2012; 7: 335-340
- The impact of digit-related radiographic osteoarthritis of the hand on grip-strength and upper extremity disability.Clin Orthop Relat Res. 2012; 470: 2202-2208
- Relationship of radiographic and clinical variables to pinch and grip strength among individuals with osteoarthritis.Arthritis Rheum. 2005; 52: 1424-1430
- The effect of hand osteoarthritis on grip and pinch strength and hand function in postmenopausal women.Clin Rheumatol. 2003; 22: 420-424
- Imaging modalities in hand osteoarthritis--and perspectives of conventional radiography, magnetic resonance imaging, and ultrasonography.Arthritis Res Ther. 2011; 13: 248
- Ultrasound detected inflammation is associated with the development of new bone erosions in hand osteoarthritis: a longitudinal study over 3.9 years.Osteoarthr Cartil. 2015; 23: 1925-1932
- Synovial inflammation drives structural damage in hand osteoarthritis: a narrative literature review.Curr Rheumatol Rev. 2017; 13: 43-50
- Radial nerve mobilisation had bilateral sensory effects in people with thumb carpometacarpal osteoarthritis: a randomised trial.J Physiother. 2013; 59: 25-30
- Spectrum of normal and pathologic findings in the region of the first hand compartment of the wrist: sonographic findings and correlations with dissections.J Ultrasound Med. 2009; 28: 779-786
- Occupational repetitive strain neuropathy.Am Fam Physician. 1992; 45: 585-592
- Interphalangeal joint sonography of symptomatic hand osteoarthritis: clinical and functional correlation.J Ultrasound Med. 2017; 36: 311-319
JHT Read for Credit
Quiz: # 873
Record your answers on the Return Answer Form found on the tear-out coupon at the back of this issue or to complete online and use a credit card, go to JHTReadforCredit.com. There is only one best answer for each question.
- # 1.In addition to screening for SRN involvement, the following were evaluated
- a.cross-sectional area of the 1st dorsal compartment
- b.X-ray of the CMC
- c.synovitis of the CMC
- d.all of the above
- a.
- # 2.The presence of SRN involvement was determined by
- a.MRI examination
- b.Hx taking
- c.electrophysiological examination
- d.M2Pd testing
- a.
- # 3.Doppler activity suggesting active inflammation was
- a.not associated with radiological damage
- b.strongly associated with radiological damage
- c.not a part of the study
- d.was negative in all patients
- a.
- # 4.There was a fair correlation between SNR involvement and
- a.only X-ray findings
- b.multiple concomitant factors
- c.only cross-sectional area of the 1st dorsal compartment
- d.none of the above
- a.
- # 5.The authors demonstrated that virtually all patients with active CMC OA have marked SRN involvement
- a.true
- b.false
- a.
When submitting to the HTCC for re-certification, please batch your JHT RFC certificates in groups of 3 or more to get full credit.
Article info
Publication history
Published online: January 11, 2021
Accepted:
January 7,
2021
Received in revised form:
December 9,
2020
Received:
July 4,
2020
Footnotes
Conflicts of interest: There is no conflict interest among the authors.
Funding: There is no funding source in this study.
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
