title: Predictors of stenosing tenosynovitis in the hand and hand-related activity limitations in patients with rheumatoid arthritis.
abstract: OBJECTIVE
  To identify early predictors of stenosing tenosynovitis in the hand and hand-related activity limitations in patients with rheumatoid arthritis (RA).
  
  
  METHODS
  A longitudinal study of an inception cohort.
  
  
  METHODS
  A large outpatient clinic.
  
  
  METHODS
  Consecutive patients who attended the Early Arthritis Clinic for at least 2 years and fulfilled the American College of Rheumatology criteria for RA at baseline and/or at the 1-year follow-up were invited to participate until 200 patients were included.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Stenosing tenosynovitis, assessed by means of a standardized physical examination. Hand-related activity limitations, assessed with the Disabilities of Arm, Shoulder and Hand questionnaire (DASH). A DASH score above the upper limit of the 95% range of the normative score was defined as abnormal. Prognostic factors: demographic and disease activity-related variables, radiographic damage, the Health Assessment Questionnaire (HAQ) total score and category scores at the 2-year follow-up.
  
  
  RESULTS
  The mean age ± SD of the patients was 59.7±10.7 years (75% female). The mean time ± SD between the 2-year follow-up and the assessment of the dependent variables was 3.9±2.7 years. Stenosing tenosynovitis was present in 33%. The median (interquartile range) DASH score was 26.7 (10.8-42.5); 30% were abnormal. Stenosing tenosynovitis was predicted by the HAQ subscale regarding the use of hands (HAQ-hand) at the 2-year follow-up (odds ratio [OR], 2.3; 95% confidence interval [CI], 1.2-4.2). Hand-related activity limitations were predicted by the Disease Activity Score in 28 joints (OR, 1.8; 95% CI, 1.3-2.4) and HAQ-hand (OR, 2.4; 95% CI, 1.3-5.8) at the 2-year follow-up.
  
  
  CONCLUSIONS
  Stenosing tenosynovitis in patients with RA was predicted by HAQ-hand at the 2-year follow-up, and hand-related activity limitations were predicted by disease activity and HAQ-hand at the 2-year follow-up.
authors.affiliation: Department of Rheumatology, Jan van Breemen Institute, Amsterdam, The Netherlands.
authors.forename: Jennie
authors.initials: J
authors.lastname: Ursum
authors.forename: Noortje C
authors.initials: NC
authors.lastname: Horsten
authors.forename: Agnes F
authors.initials: AF
authors.lastname: Hoeksma
authors.forename: Ben A
authors.initials: BA
authors.lastname: Dijkmans
authors.forename: Dirk L
authors.initials: DL
authors.lastname: Knol
authors.forename: Dirkjan
authors.initials: D
authors.lastname: van Schaardenburg
authors.forename: Joost
authors.initials: J
authors.lastname: Dekker
authors.forename: Leo D
authors.initials: LD
authors.lastname: Roorda
mesh_terms: D000368:Aged; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D001175:Arthrography; D004185:Disability Evaluation; D005260:Female; D005528:Foot / Q000000981:diagnostic imaging; D006225:Hand / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006304:Health Status; D006801:Humans; D007596:Joints / Q000473:pathology / Q000503:physiopathology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D011379:Prognosis; D012959:Socioeconomic Factors; D053682:Tendon Entrapment / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology