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Radiocarpal and Midcarpal Instability in Rheumatoid Patients: A Systematic Review.

Raven EE, van den Bekerom MP, Beumer A, van Dijk CN - Open Orthop J (2015)

Bottom Line: Results.In the search 108 articles were found, of these 12 studies were included for this review.A strong correlation was found between instability, duration of RA and Larsen score.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery and Traumatology of the Gelre Hospitals, Postbus 9014, 7300 DS Apeldoorn, The Netherlands.

ABSTRACT

Background: This study was aimed at identifying the criteria for the diagnosis of Radiocarpal instability in rheumatoid arthritis RA).

Methods: The main databases were searched to identify studies describing the pathophysiology of Radiocarpal instability in patients with RA. We focussed on the epidemiology, radiographic parameters, criteria for instability and on treatment options. Results. In the search 108 articles were found, of these 12 studies were included for this review. Instability occurs in at an average of 35.2% of the rheumatoid wrists. The instability was found between 8 and 13 years after onset of rheumatoid arthritis. A strong correlation was found between instability, duration of RA and Larsen score. Several radiographic methods were described to evaluate Radiocarpal instability in RA. Several treatment options for instability in patients with RA are described. All with their own indications and limitations.

Conclusion: On a standard AP radiograph deformity can be measured using the carpal height and the ulnar translation index of Chamay. This gives an indication for instability. For describing the deterioration of the joints the Larsen score is most used. If there are more radiographs in time the Simmen classification can be used. For real assessment of instability dynamic radiographs are needed.

Level of evidence: Level IV.

No MeSH data available.


Related in: MedlinePlus

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Figure 1: Flowchart summarizing the selection of relevant articles.

Mentions: The search of the literature performed in this study was limited to published original studies including male and/or female patients with uni- or bilateral rheumatoid arthritis of the wrist. Rheumatoid arthritis was defined with revised criteria for the classification of rheumatoid arthritis of the American Rheumatism Association [7]. All types of instability of the rheumatoid wrist in humans were included. Articles concerning instability of the distal radio ulnar joint were not included in this review, except when the patients with Radiocarpal and Midcarpal instability could be analysed separately. Only original published studies were included; review articles, expert opinions and abstracts from scientific meetings were excluded. The main databases Pubmed/ MEDLINE, Cochrane Clinical Trial Register, Current Controlled Trials and EMBASE were searched from 1968 to September 2013 to identify studies relating to the patho-physiology, prevention, diagnosis, treatment and prognosis of radio- and Midcarpal instability in patients with rheumatoid arthritis of the wrist (Fig. 1).


Radiocarpal and Midcarpal Instability in Rheumatoid Patients: A Systematic Review.

Raven EE, van den Bekerom MP, Beumer A, van Dijk CN - Open Orthop J (2015)

Flowchart summarizing the selection of relevant articles.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4591907&req=5

Figure 1: Flowchart summarizing the selection of relevant articles.
Mentions: The search of the literature performed in this study was limited to published original studies including male and/or female patients with uni- or bilateral rheumatoid arthritis of the wrist. Rheumatoid arthritis was defined with revised criteria for the classification of rheumatoid arthritis of the American Rheumatism Association [7]. All types of instability of the rheumatoid wrist in humans were included. Articles concerning instability of the distal radio ulnar joint were not included in this review, except when the patients with Radiocarpal and Midcarpal instability could be analysed separately. Only original published studies were included; review articles, expert opinions and abstracts from scientific meetings were excluded. The main databases Pubmed/ MEDLINE, Cochrane Clinical Trial Register, Current Controlled Trials and EMBASE were searched from 1968 to September 2013 to identify studies relating to the patho-physiology, prevention, diagnosis, treatment and prognosis of radio- and Midcarpal instability in patients with rheumatoid arthritis of the wrist (Fig. 1).

Bottom Line: Results.In the search 108 articles were found, of these 12 studies were included for this review.A strong correlation was found between instability, duration of RA and Larsen score.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery and Traumatology of the Gelre Hospitals, Postbus 9014, 7300 DS Apeldoorn, The Netherlands.

ABSTRACT

Background: This study was aimed at identifying the criteria for the diagnosis of Radiocarpal instability in rheumatoid arthritis RA).

Methods: The main databases were searched to identify studies describing the pathophysiology of Radiocarpal instability in patients with RA. We focussed on the epidemiology, radiographic parameters, criteria for instability and on treatment options. Results. In the search 108 articles were found, of these 12 studies were included for this review. Instability occurs in at an average of 35.2% of the rheumatoid wrists. The instability was found between 8 and 13 years after onset of rheumatoid arthritis. A strong correlation was found between instability, duration of RA and Larsen score. Several radiographic methods were described to evaluate Radiocarpal instability in RA. Several treatment options for instability in patients with RA are described. All with their own indications and limitations.

Conclusion: On a standard AP radiograph deformity can be measured using the carpal height and the ulnar translation index of Chamay. This gives an indication for instability. For describing the deterioration of the joints the Larsen score is most used. If there are more radiographs in time the Simmen classification can be used. For real assessment of instability dynamic radiographs are needed.

Level of evidence: Level IV.

No MeSH data available.


Related in: MedlinePlus