The prevalence of tenosynovitis of the interosseous tendons of the hand in patients with rheumatoid arthritis

• Published in: European radiology Vol. 26; no. 2; pp. 444 - 450
• Main Authors: Rowbotham, Emma L., Freeston, Jane E., Emery, Paul, Grainger, Andrew J.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.02.2016; Springer Nature B.V
• Subjects: Adult; Aged; Arthritis, Rheumatoid - epidemiology; Arthritis, Rheumatoid - pathology; Biomedical research; Comorbidity; Diagnostic Radiology; Female; Hand - pathology; Humans; Imaging; Imaging, Three-Dimensional; Internal Medicine; Interventional Radiology; Magnetic Resonance Imaging; Male; Medicine; Medicine & Public Health; Metacarpophalangeal Joint - pathology; Middle Aged; Musculoskeletal; Neuroradiology; Prevalence; Radiology; Rheumatoid arthritis; Tendons; Tendons - pathology; Tenosynovitis - epidemiology; Tenosynovitis - pathology; Ultrasonic imaging; Ultrasound; Young Adult; United Kingdom > UK; Synovitis; Inflammation; Magnetic resonance imaging; Rheumatoid arthritis; Interosseous tendons
• ISSN: 0938-7994; 1432-1084
• DOI: 10.1007/s00330-015-3859-0

Aim The aim of this study was to establish the prevalence of tenosynovitis affecting the interosseous tendons of the hand in a rheumatoid arthritis (RA) population and to assess for association with metacarpophalangeal (MCP) joint synovitis, flexor tendon tenosynovitis or ulnar drift. Methods Forty-four patients with RA underwent hand MRI along with 20 normal controls. Coronal 3D T1 VIBE sequences pre- and post-contrast were performed and reconstructed. The presence of interosseous tendon tenosynovitis was recorded alongside MCP joint synovitis, flexor tendon tenosynovitis and ulnar drift. Results Twenty-one (47.7 %) patients with RA showed interosseous tendon tenosynovitis. Fifty-two (14.8 %) interosseous tendons showed tenosynovitis amongst the RA patients. Interosseous tendon tenosynovitis was more commonly seen in association with adjacent MCP joint synovitis (p < 0.001), but nine MCP joints (5.1 %) showed adjacent interosseous tenosynovitis in the absence of joint synovitis. Interosseous tendon tenosynovitis was more frequently seen in fingers which also showed flexor tendon tenosynovitis (p < 0.001) and in patients with ulnar drift of the fingers (p = 0.01). Conclusion Tenosynovitis of the hand interosseous tendons was found in 47.7 % of patients with RA. In the majority of cases this was adjacent to MCP joint synovitis; however, interosseous tendon tenosynovitis was also seen in isolation. Key Points • Tenosynovitis of the interosseous tendons of the hand occurs in rheumatoid arthritis. • Interosseous tendon tenosynovitis has a prevalence of 47.7 % in patients with RA. • Interosseous tendon tenosynovitis is related to MCP joint synovitis in the adjacent joints.