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Bilateral fast MR imaging of the rheumatoid wrist

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Summary

To evaluate the structural changes in the carpal tunnel and possible intrinsic median nerve damages in RA patients, quantitative bilateral magnetic resonance imaging (MRI) of the wrists was performed by means of a fast imaging sequence. Thirty-three women with RA and 42 controls were examined. The length of the carpal tunnel, the carpal tunnel volume/wrist volume (CTV/WV) ratio and the signal intensity of the nerve were calculated in both groups, bilaterally. The CTV/WV ratio was 0.12 in the patients and 0.11 in the control group (p=0.007). A negative association was found between disease duration and carpal tunnel volume/wrist volume ratio (p=0.049). Mean distal latency in the right motor median nerve was 3.0±0.4 msec (patients) and 3.4±0.6 msec (controls) (p=0.002). Mean values in the right sensory branch were 1.2±0.1 msec (patients) and 1.4±0.3 (controls) (p=0.01). The lack of association between the size of the carpal canal and neurophysiological parameters found in this study may suggest a possible protection of the median nerve by the increased canal size in patients with RA.

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References

  1. Resnick D. Diagnosis of Bone and Joint Disorders, 2d ed. W.B Saunders Co.,, 1988,955–990.

  2. Brook A, Fleming A, Corbett M. Relationship of radiological change to clinical outcome in rheumatoid arthritis. Ann Rheum Dis 1977,36,274–276.

    PubMed  Google Scholar 

  3. Fuchs HA, Kaye JJ, Callahan LF, Nance EP, Pincus T. Evidence of significant radiographic damage in rheumatoid arthritis within the first 2 years of disease. J Rheumatol 1989,16,585–591.

    PubMed  Google Scholar 

  4. Gilkeson G, Polisson R, Sinclair H, et al. Early detection of carpal erosions in patients with rheumatoid arthritis: a pilot study of magnetic resonance imaging. J Rheumatol 1988,15,1361–1366.

    PubMed  Google Scholar 

  5. Foley-Nolan D, Stack JP, Ryan M, et al. Magnetic resonance imaging in the assessment of rheumatoid arthritis — a comparison with plain film radiographs. Br J Rheumatol 1991,30,101–106.

    PubMed  Google Scholar 

  6. Pierre-Jerome C, Shahabpour M, Osteaux M. Bilateral MR imaging of the wrist. Evaluation of pre and postoperative carpal tunnel syndrome. Radiology 1989,173,504.

    Google Scholar 

  7. Lacotte B, Pierre-Jerome C, Coessens B, Shahabpour M, Durdu J. Le syndrome du canal carpien. Etudes comparatives pre- et post-operatoires entre resonance magnetique et electromyographie. Ann Chir Main 1991,10,300–307.

    Article  Google Scholar 

  8. Lang AH, Kalliomaki L, Puusa A, Halonen JP. Sensory neuropathy in rheumatoid arthritis: an electroneurographic study. Scand J Rheum 1981,10,81–84.

    PubMed  Google Scholar 

  9. Arnett FC, Edworthy SM, Bloch DA, et al. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 1988,31,315–324.

    PubMed  Google Scholar 

  10. Boas ML. Mathematical Methods in the Physical Science. 2nd ed. John Wiley & Sons, Inc, 1983, 153

  11. Ritchie D, Boyle J, McInnes J, et al. Clinical studies with an articular index for the assessment of joint tenderness in patients with rheumatoid arthritis. Q J Med 1968,147,393–406.

    Google Scholar 

  12. Pallis CA, Scott JT. Peripheral neuropathy in rheumatoid arthritis. Br Med J 1965,1,1141–1147.

    Google Scholar 

  13. Weller RO, Bruckner FE, Chamberlain A. Rheumatoid neuropathy: a histological and electrophysiological study. J Neurol Neurosurg Psychiatry 1970,33,592–604.

    PubMed  Google Scholar 

  14. Kim RC, Collins GH. The neuropathology of rheumatoid disease. Human pathology 1981,12,5–15.

    PubMed  Google Scholar 

  15. Dawson DM. Entrapment neuropathies of the upper extremities. N Engl J Med 1993,27,2013–2018.

    Article  Google Scholar 

  16. Dekel S, Coates R. Primary carpal stenosis as a cause of “idiopathic” carpal- tunnel syndrome. Lancet 1979,2,2014.

    Google Scholar 

  17. Winn FJ Jr, Habes DJ. Carpal tunnel area as a risk factor for carpal tunnel syndrome. Muscle Nerve 1990,13,254–258.

    PubMed  Google Scholar 

  18. Meske S, Friedburg H, Hennig J, Reinbold W, Stappert K, Schumichen C. Rheumatoid arthritis lesions of the wrist examined by rapid gradient-echo magnetic resonance imaging. Scand J Rheum 1990,19,235–238.

    PubMed  Google Scholar 

  19. Stoller DW. Magnetic Resonance Imaging in Orthopaedics and Sports Medicine. J.B.Lippincott Co. 1993,683–806.

  20. Coyle MP. Nerve entrapment syndromes in the upper extremity. In: Principles of Orthopaedic Practice. Vol 1. Ed.: Dee R., New York: Mc Graw-Hill, 1989:672.

    Google Scholar 

  21. Waxman SG. Determinants of conduction velocity in myelinated nerve fibers. Muscle Nerve 1980;3:141.

    Article  PubMed  Google Scholar 

  22. Silverstein BA, Fine LJ, Armstrong T. Occupational factors and carpal tunnel syndrome. Am J Ind Med 1987;11:343–358.

    PubMed  Google Scholar 

  23. Morgenstern H, Kelsh M, Kraus J, Margolis W. A cross-sectional study of hand/wrist symptoms in female grocery checkers. Am J Ind Med 1991;20:209–218.

    PubMed  Google Scholar 

  24. Armstrong TJ, Foulke JA, Joseph BS, et al. Investigation of cumulative trauma disorders in a poultry processing plant. Am Ind Hyg Assoc J 1982;43:103.

    PubMed  Google Scholar 

  25. Masear VR, Hayes JM, Hyde AG. An industrial cause of carpal tunnel syndrome. J Hand Surg 1986; 11A:222.

    Google Scholar 

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Pierre-Jerome, C., Bekkelund, S.I., Husby, G. et al. Bilateral fast MR imaging of the rheumatoid wrist. Clin Rheumatol 15, 42–46 (1996). https://doi.org/10.1007/BF02231683

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