Sensitivity and Specificity of the Automated Squeeze Test (Gaenslen’s Maneuver) For Identifying Metacarpophalangeal Synovitis By Magnetic Resonance Imaging

David Vega-Morale

doi:10.34297/ajbsr.2020.08.001309

Abstract

To determine the diagnostic performance of the automated squeeze test (AST) on the metacarpophalangeal (MCP) joints to detect the presence of synovitis, edema or erosions by magnetic resonance imaging (MRI) by using the rheumatoid arthritis magnetic resonance imaging score (RAMRIS) in first-degree relatives (FDR) of Rheumatoid Arthritis (RA) patients with hand arthralgia and RA patients.

Highlights

Identification and treatment of rheumatoid arthritis (RA) patients prevent joint destruction, deformity, and disability [1]
The aim of this study is to determine the diagnostic performance of the automated squeeze test (AST) on the MCP joints to detect the presence of synovitis, edema or erosions by magnetic resonance imaging (MRI) using the rheumatoid arthritis magnetic resonance imaging score (RAMRIS) [11,12,13] in first-degree relatives (FDR) of RA patients, of whom Clinical Suspect Arthralgia (CSA) in hands was suspected, as well as in RA patients
The inclusion criteria consisted in both sexes subjects older than 18 years-old, with RA diagnosis according to the ACR/EULAR 2010 classification criteria, with positive rheumatoid factor (RF) or anti-citrullinated peptide antibodies (ACPA’s), recent (

Summary

Introduction

Identification and treatment of rheumatoid arthritis (RA) patients prevent joint destruction, deformity, and disability [1]. The squeeze test (ST) or Gaenslen’s compression maneuver (GCM) positivity is characterized by tenderness upon lateral compression (squeezing) of the metacarpophalangeal (MCP) joints on a patient who has active synovitis [4,5] The performance of this maneuver is included in several early referral strategies [6]. EULAR has established Clinical Suspect Arthralgia (CSA) as a definition, consisting in a set of seven parameters that describe patients with arthralgia with no definite diagnosis but a suspicion of progression to RA, within these parameters the positive ST is included [7] It has been demonstrated the presence of variability in the ST performance among rheumatologists, reporting that, in one second of compression, the force ranges between 0.400 kg/s2 and 1.0 kg, using the right hand and a superior approach on the MCP joints when performing the maneuver [8,9]. We have found that the mean force taken to evoke pain in patients with RA is 3.07 and 2.78 kg in right and left hand, respectively, in contrast to patients without arthritis who required 4.2 and 4.6 kg [10]

Methods

Results

Discussion

Conclusion