Abstract
Osteoarthritis is a common degenerative disease that most frequently involves the hand. The objective was to compare clinical functional outcome measures including hand grip, pinch strength, and dexterity with various electrophysiological measures in patients of different ages with hand osteoarthritis with or without the presence of carpal tunnel syndrome (CTS). Patients with hand osteoarthritis (208 patients, 404 hands) who underwent hand-function tests and motor and sensory nerve conduction studies (NCS) between June 2015 and June 2016 were enrolled. The patients’ hands were assigned to carpal tunnel syndrome (CTS) (206 hands; mean age, 56.37 ± 10.52; male:female, 46:160) or control groups (198 hands; mean age, 57.88 ± 9.68; male:female, 55:143). The strength of hand grip and lateral pinch, the time required to complete the nine-hole pegboard test (9HPT), and motor and sensory nerve conduction parameters were measured and compared across age groups and between hands with or without CTS. The CTS group showed significantly lower hand grip and lateral pinch strength, and a longer time to complete the 9HPT in comparison with the control group. Female patients showed significantly lower hand grip and lateral pinch strength than male patients. However, there was no difference in the 9HPT completion time between genders. Multivariate regression analysis identified the amplitude of the median compound muscle action potential (CMAP), age, and male gender as independent predictors of grip strength (adjusted R2 = 0.679), and amplitude of median CMAP and male gender as independent predictors of KP strength (adjusted R2 = 0.603). Velocity of median CMAP, amplitude of median sensory nerve action potential, and age were identified as independent predictors of 9HPT time (adjusted R2 = 0.329). Nerve conduction measurements were significantly related to hand-function test results, and CTS induced significant deficits in strength and performance of the affected hand.
Highlights
Osteoarthritis is a common degenerative disease that most frequently involves the hand
Despite several previous studies reporting a causal link between CTS and basal thumb osteoarthritis[6,7], Shin et al suggested that basal thumb osteoarthritis was not more prevalent in a CTS group, compares with a non-CTS group, and that the radiographic severity of basal joint arthritis of the thumb was not related to the electrophysiological severity of carpal tunnel syndrome in elderly Korean s ubjects[8]
Our study found that electrophysiological parameters, especially those of the median motor nerve, were strong predictors of the results of hand-function tests in hand osteoarthritis patients
Summary
Osteoarthritis is a common degenerative disease that most frequently involves the hand. The strength of hand grip and lateral pinch, the time required to complete the nine-hole pegboard test (9HPT), and motor and sensory nerve conduction parameters were measured and compared across age groups and between hands with or without CTS. Nerve conduction studies (NCS) are a standard method for diagnosing peripheral neuropathy including CTS, and both high sensitivity and specificity are reported in numerous s tudies[11], there remains some controversy over their validity, because other studies have reported relatively high rates of false negative and false-positive tests[12] These might be caused by the wide range of reference values for both distal sensory latency (DSL) and distal motor latency (DML) for diagnosis of CTS. Khosrawi and Dehghan[11] suggested a DSL cut-off of 3.6 ms with a sensitivity of 87% and specificity of 91%, and a DML cut-off of 4.2 ms with a sensitivity of 70% and specificity of 100%, and these values have been widely used for the electromyographical diagnosis of CTS in Korean rehabilitation medicine
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