Relationship between roentgenographic joint destruction in the hands and functional disorders among patients with rheumatoid arthritis.
OBJECTIVE
Although a relationship between joint destruction and functional disorders seems apparent in patients with rheumatoid arthritis (RA), it has not been well proven in the literature. The aims of this study were to clarify the relationship between roentgenographic joint destruction in the hands and functional disorders in patients with RA, and to explore the appropriate assessment measures for functional disorders.


METHODS
Cross-sectional data of the Genant-modified Total Sharp Score (Genant-mTSS), Health Assessment Questionnaire-Disability Index (HAQ-DI), Disabilities of the Arm, Shoulder, and Hand (DASH), and Michigan Hand Outcomes Questionnaire (MHQ) were collected from 50 consecutive RA patients and analyzed.


RESULTS
HAQ-DI, DASH, and MHQ had close correlations with Genant-mTSS, with correlation coefficients of 0.69, 0.71, and -0.70, respectively, among patients with low disease activity (DAS28 < 3.2). A floor effect was observed in HAQ-DI, but neither floor nor ceiling effects were observed in DASH and MHQ. Both DASH and MHQ were strongly correlated with HAQ-DI, with correlation coefficients of 0.87 and 0.73, respectively.


CONCLUSIONS
Functional disorders had significant relationships with roentgenographic joint destruction in the hands among RA patients with low disease activity. As assessment measures of functional disorders, DASH and MHQ had no floor or ceiling effects, being different from HAQ-DI.
a Department of Orthopaedic Surgery, Faculty of Medicine , The University of Tokyo , Tokyo , Japan.|b Department of Orthopaedic Surgery , Teikyo University Mizonokuchi Hospital , Kanagawa , Japan.
Tetsuro
T
Yasui
c Department of Medical Research and Management for Musculoskeletal Pain , 22nd Century Medical & Research Center, Faculty of Medicine, The University of Tokyo , Tokyo , Japan , and.
Hiroyuki
H
Oka
a Department of Orthopaedic Surgery, Faculty of Medicine , The University of Tokyo , Tokyo , Japan.
Yasunori
Y
Omata
d Department of Orthopaedic Surgery , Saitama Medical University , Saitama , Japan.
Yuho
Y
Kadono
a Department of Orthopaedic Surgery, Faculty of Medicine , The University of Tokyo , Tokyo , Japan.
Sakae
S
Tanaka
D000328:Adult; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000503:physiopathology; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D050823:Hand Joints / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D000071066:Patient Reported Outcome Measures; D011859:Radiography / Q000379:methods*; D016059:Range of Motion, Articular; D011795:Surveys and Questionnaires
Disabilities of the Arm; Health Assessment Questionnaire; Michigan Hand Outcomes Questionnaire; Patient reported outcomes; Shoulder; Total Sharp Score; and Hand