BACKGROUND: A common adage among hand surgeons is that the symptoms of trapeziometacarpal (TMC) arthrosis vary among patients independent of the radiographic severity. We studied factors associated with radiographic severity of TMC arthrosis, thumb pain, thumb-specific disability, pinch strength, and grip strength in patients not seeking care for TMC arthrosis. Our primary null hypothesis was that there are no factors independently associated with radiographic severity of TMC arthrosis according to the Eaton classification among patients not seeking care for TMC arthrosis. METHODS: We enrolled 59 adult patients not seeking care for TMC arthrosis. We graded patients' radiographic TMC arthrosis and asked all patients to complete a set of questionnaires: demographic survey, pain scale, TMC joint arthrosis-related symptoms and disability questionnaire (TASD), and a depression questionnaire. Metacarpophalangeal hyperextension and pinch and grip strength were measured, and the grind test and shoulder sign were performed. RESULTS: Older age was the only factor associated with more advanced radiographic pathophysiology of TMC arthrosis. One in 5 patients not seeking care for TMC arthrosis experienced thumb pain; no factors were independently associated with having pain or limitations related to TMC arthrosis. Youth and male sex were associated with stronger pinch and grip strength. CONCLUSIONS: There are a large number of patients with relatively asymptomatic TMC arthrosis. Metacarpophalangeal hyperextension and female sex may have a relationship with symptoms, but further study is needed. Our data support the concept that TMC arthrosis does not correlate with radiographic arthrosis.
BACKGROUND: A common adage among hand surgeons is that the symptoms of trapeziometacarpal (TMC) arthrosis vary among patients independent of the radiographic severity. We studied factors associated with radiographic severity of TMC arthrosis, thumb pain, thumb-specific disability, pinch strength, and grip strength in patients not seeking care for TMC arthrosis. Our primary null hypothesis was that there are no factors independently associated with radiographic severity of TMC arthrosis according to the Eaton classification among patients not seeking care for TMC arthrosis. METHODS: We enrolled 59 adult patients not seeking care for TMC arthrosis. We graded patients' radiographic TMC arthrosis and asked all patients to complete a set of questionnaires: demographic survey, pain scale, TMC joint arthrosis-related symptoms and disability questionnaire (TASD), and a depression questionnaire. Metacarpophalangeal hyperextension and pinch and grip strength were measured, and the grind test and shoulder sign were performed. RESULTS: Older age was the only factor associated with more advanced radiographic pathophysiology of TMC arthrosis. One in 5 patients not seeking care for TMC arthrosis experienced thumb pain; no factors were independently associated with having pain or limitations related to TMC arthrosis. Youth and male sex were associated with stronger pinch and grip strength. CONCLUSIONS: There are a large number of patients with relatively asymptomatic TMC arthrosis. Metacarpophalangeal hyperextension and female sex may have a relationship with symptoms, but further study is needed. Our data support the concept that TMC arthrosis does not correlate with radiographic arthrosis.
Authors: Stéphanie J E Becker; Dennis J S Makarawung; Silke A Spit; John D King; David Ring Journal: J Hand Surg Am Date: 2014-09-04 Impact factor: 2.230