Carpal collapse in rheumatoid arthritis--prevalence and clinical significance: a preliminary study.

Abstract

To evaluate the prevalence and clinical significance of carpal collapse in Mexican women with rheumatoid arthritis (RA). We evaluated the carpal height ratio (CHR) of 97 women with RA and 90 healthy women. Using plain radiographs of both hands, measurements were performed by 2 radiologists in a single blind fashion. We analyzed functional class, characteristics and duration of the disease, and presence of rheumatoid factor (RF). CHR values of the controls were 0.49+/-0.02 (values reported in American Caucasian women are 0.54+/-0.04). Thirty-five patients had carpal collapse (defined as CHR < or = 0.43) in the right hand, 30 in the left hand, and 23 bilaterally. Carpal collapse was associated with RF seropositivity and roentgenographic degree of progression (p < 0.01), as well as with cumulative dose of steroids. As 95% of the patients were right-handed, dexterity was not apparently affected. We observed no differences in Health Assessment Questionnaire, functional class, or disease duration between patients with and those without carpal collapse. The definition of carpal collapse may have ethnic related differences. Carpal collapse is common in Mexican women with RA and it is not an indicator of functional limitations.