Objective To characterise the frequency and influence of tenosynovitis and tendon damage on pain and hand function using clinical examination and ultrasound (US) in hand osteoarthritis (HOA). Methods We included 86 patients with HOA and 23 age- and sex-matched control subjects. Extensor and flexor tendons of both hands were assessed by clinical examination and US for tenosynovitis, tendon damage. Conventional radiographs were acquired. Hand function was evaluated by the function subtest of the M-SACRAH questionnaire and the Moberg pick-up test. K-means cluster analyses was calculated to assess clusters based on radiographic features and sonographic tendon scores. Results Ultrasound identified the involvement of ≥ 1 tendon in 60/86 (69.8%) HOA patients compared with 2/23 (8.7%) subjects (p< 0.01) in the control group. In the HOA group, US detected tendon damage more often in flexor tendons compared with extensor tendons (2.1% 0.9%, p= 0.03), while tenosynovitis was observed more often in extensor tendons compared with flexor tendons (8% vs 0.6%, p< 0001). The sensitivity and specificity of clinical examination to detect tendon involvement was 81.4% and 34.6%, respectively on the patient level and 14.5% and 83.8% on the tendon level. The cluster analyses revealed one cluster with more radiographic features of HOA and more tendon damage while more tenosynovitis was found in cluster 2. M-SACRAH function did not correlate with tendon involvement on US. Conclusion This study revealed a high frequency of tendon involvement in HOA. Tendon involvement on US did not impact hand function or self-reported pain.

中文翻译：

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手部骨关节炎患者的肌腱受累及其与疼痛和手功能的关系


目的 通过手骨关节炎 (HOA) 的临床检查和超声 (US) 来表征腱鞘炎和肌腱损伤的发生频率以及对疼痛和手功能的影响。方法 我们纳入了 86 名 HOA 患者和 23 名年龄和性别匹配的对照受试者。通过临床检查和超声评估双手的伸肌腱和屈肌腱是否存在腱鞘炎、肌腱损伤。获取常规射线照片。手部功能通过M-SACRAH问卷的功能子测试和Moberg拾取测试进行评估。计算 K 均值聚类分析，以根据放射学特征和超声肌腱评分评估聚类。结果 超声检查发现 60/86 (69.8%) HOA 患者受累≥ 1 根肌腱，而对照组为 2/23 (8.7%) (p< 0.01)。在 HOA 组中，与伸肌腱相比，超声在屈肌腱中更常见肌腱损伤 (2.1% 0.9%，p = 0.03)，而与屈肌腱相比，伸肌腱中更常见腱鞘炎 (8% vs 0.6%，p = 0.03)。 < 0001）。临床检查检测肌腱受累的敏感性和特异性在患者水平上分别为 81.4% 和 34.6%，在肌腱水平上分别为 14.5% 和 83.8%。聚类分析显示，第 1 簇具有更多 HOA 放射学特征和更多肌腱损伤，而第 2 簇中发现更多腱鞘炎。M-SACRAH 功能与 US 上的肌腱受累无关。结论 这项研究揭示了 HOA 中肌腱受累的频率较高。美国肌腱受累不会影响手部功能或自我报告的疼痛。