ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 2277

Midcarpal Joint Effusion Is As Common As Radiocarpal Joint Effusion In Swollen Wrists Of Patients With Rheumatoid Arthritis

Jae Ho Lee1, Young Sun Suh1, Jung Hee Koh1, Seung Min Jung2, Jennifer Lee1, Ji Yeon Lee3, Soo Young Lee4, Seung-Ki Kwok1, Ji Hyeon Ju1, Kyung-Su Park1, Dae Chul Jeong5 and Sung Hwan Park1, 1Division of Rheumatology, Department of Internal Medicine, School of Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, South Korea, 2Division of Rheumatology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea, 3Division of Rheumatology, Department of Internal Medicine, School of Medicine, The Catholic University of Korea, Seoul St. Mary’s Hospital, Seoul, South Korea, 4Department of Pediatrics, School of Medicine, The Catholic University of Korea, Incheon St. Mary's Hospital, Incheon, South Korea, 5Division of Rheumatology, Department of Pediatrics, School of Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, South Korea

Meeting: 2013 ACR/ARHP Annual Meeting

Keywords:

Session Information

Title: Rheumatoid Arthritis-Clinical Aspects III: Outcome Measures, Socioeconomy, Screening, Biomarkers in Rheumatoid Arthritis

Session Type: Abstract Submissions (ACR)

Background/Purpose: Wrist joint is most commonly involved in rheumatoid arthritis (RA) and consists of multiple compartments; radiocarpal, midcarpal, and carpometacarpal joints. Intraarticular corticosteroid injection is usually done into radiocarpal joint for wrist joint swelling. However, it is hard to expect that drug injected into the radiocarpal joint spread to other compartments of wrist joint.To identify the distribution of joint effusions in swollen wrist joints of patients with RA and examine the effect of intraarticular corticosteroid injection into multiple compartments of wrist joints.

Methods: In RA patients with wrist joint swelling, we examined the distribution of joint effusion (radiocarpal, midcarpal, and carpometacarpal joints and extensor digitorum tendons) using musculoskeletal ultrasound.

Results:

Twenty-seven patients presented with wrist joint swelling including 3 patients with both wrists involved and total of 30 wrist joints were examined. Twenty patients were female (74%), mean age was 55.8 ± 11.8 years, and mean disease duration was 62.5 ± 61.22 months. Twenty-four patients (88.9%) were seropositive and 9 patients (33.3%) had been treated with anti-TNF agents. Radio-carpal joint effusion was present in all 30 swollen wrist joints. Of note, effusion was found in midcarpal joints of 28 swollen wrists (93.3%). Among midcarpal joints, lunate-capitate joint was most commonly involved (n=28), followed by lunate-hamate joint (n=26), scaphoid-trapezoid joint (n=25), and triquetrum-hamate joint (n=25). In 15 wrists, effusion was also found in carpometacarpal joints (CMC); 4th CMC joint (n=10), 5th CMC joint (n=9), 3rd CMC joint (n=6), and 2nd CMC joint (n=2). Extensor digitorum tendons were involved in 3 wrists. We injected corticosteroid into both radiocarpal and midcarpal joints in 7 wrists and 6 of them (85.7%) showed marked improvement in pain and swelling at the next visit.

Conclusion:

Midcarpal joint effusion is as common as radiocarpal joint effusion in swollen wrists of patients with RA. This suggests that, in patients with wrist joint swelling, not only radicarpal joint but also midcarpal joint should be considered for intraarticular corticosteroid injection.

Disclosure:

J. H. Lee,
None;

Y. S. Suh,
None;

J. H. Koh,
None;

S. M. Jung,
None;

J. Lee,
None;

J. Y. Lee,
None;

S. Y. Lee,
None;

S. K. Kwok,
None;

J. H. Ju,
None;

K. S. Park,
None;

D. C. Jeong,
None;

S. H. Park,
None.

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