Objective To characterize the frequency and influence of tenosynovitis and tendon damage on pain and hand function using clinical examination and US in hand OA. Methods We included 86 patients with hand OA and 23 age- and sex-matched control subjects. Extensor and flexor tendons of both hands were assessed by clinical examination and US for tenosynovitis and tendon damage. Conventional radiographs were acquired. Hand function was evaluated by the function subtest of the M-SACRAH (modified Score for the Assessment and Quantification of Chronic Rheumatoid Affections of the Hands) 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 US identified the involvement of one or more tendon in 60/86 (69.8%) hand OA patients compared with 2/23 (8.7%) subjects (P < 0.01) in the control group. In the hand OA group, US detected tendon damage more often in flexor tendons compared with extensor tendons (2.1% vs 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 hand OA 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 hand OA. Tendon involvement on US did not impact hand function or self-reported pain.

中文翻译：

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手骨关节炎患者肌腱受累及其与疼痛和手功能的关系


目的 通过临床检查和 US in hand OA 描述腱鞘炎和肌腱损伤对疼痛和手部功能的频率和影响。方法 我们纳入了 86 例手部 OA 患者和 23 例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伸肌和屈肌腱的腱鞘炎和肌腱损伤。获取常规 X 光片。通过 M-SACRAH （手部慢性类风湿病评估和量化的改良评分） 问卷和 Moberg 拾取测试的功能子测试评估手功能。计算 K-means 聚类分析以根据影像学特征和超声肌腱评分评估聚类。结果 US 发现 60/86 （69.8%） 手部 OA 患者存在一根或多根肌腱受累，而对照组为 2/23 （8.7%） 受试者 （P < 0.01）。在手部 OA 组中，与伸肌腱相比，US 在屈肌腱中更常检测到肌腱损伤 （2.1% vs 0.9%，P = 0.03），而与屈肌腱相比，伸肌腱更常观察到腱鞘炎 （8% vs 0.6%，P < 0001）。临床检查检测肌腱受累的敏感性和特异性在患者水平分别为 81.4% 和 34.6%，在肌腱水平分别为 14.5% 和 83.8%。整群分析显示，一个集群具有更多的手部 OA 影像学特征和更多的肌腱损伤，而在集群 2 中发现了更多的腱鞘炎。M-SACRAH 功能与 US 的肌腱受累无关。结论 本研究揭示了手部 OA 肌腱受累的频率很高。US 的肌腱受累不会影响手部功能或自我报告的疼痛。