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Has the median nerve involvement in rheumatoid arthritis been overemphasized? / O envolvimento do nervo mediano na artrite reumatoide tem sido excessivamente valorizado?
Sakthiswary, Rajalingham; Singh, Rajesh.
  • Sakthiswary, Rajalingham; Universiti Kebangsaan Malaysia. Medical Centre. Department of Medicine. Cheras. MY
  • Singh, Rajesh; Universiti Kebangsaan Malaysia. Medical Centre. Department of Medicine. Cheras. MY
Rev. bras. reumatol ; 57(2): 122-128, Mar.-Apr. 2017. tab, graf
Article in English | LILACS | ID: biblio-844222
ABSTRACT
Abstract Rheumatoid arthritis (RA) is a well and widely recognized cause of carpal tunnel syndrome (CTS). In the rheumatoid wrist, synovial expansion, joint erosions and ligamentous laxity result in compression of the median nerve due to increased intracarpal pressure. We evaluated the published studies to determine the prevalence of CTS and the characteristics of the median nerve in RA and its association with clinical parameters such as disease activity, disease duration and seropositivity. A total of 13 studies met the eligibility criteria. Pooled data from 8 studies with random selection of RA patients revealed that 86 out of 1561 (5.5%) subjects had CTS. Subclinical CTS, on the other hand, had a pooled prevalence of 14.0% (30/215). The cross sectional area of the median nerve of the RA patients without CTS were similar to the healthy controls. The vast majority of the studies (8/13) disclosed no significant relationship between the median nerve findings and the clinical or laboratory parameters in RA. The link between RA and the median nerve abnormalities has been overemphasized throughout the literature. The prevalence of CTS in RA is similar to the general population without any correlation between the median nerve characteristics and the clinical parameters of RA.
RESUMO
Resumo A artrite reumatoide (AR) é uma causa bem e amplamente reconhecida de síndrome do túnel do carpo (STC). No punho acometido pela artrite reumatoide, a expansão sinovial, as erosões articulares e a frouxidão ligamentar resultam em compressão do nervo mediano decorrente do aumento da pressão intracarpal. Avaliaram-se os estudos publicados para determinar a prevalência de STC e as características do nervo mediano na AR e sua associação com parâmetros clínicos, como a atividade e duração da doença e a soropositividade. Preencheram os critérios de elegibilidade 13 estudos. Os dados agrupados dos oito estudos com seleção aleatória de pacientes com AR revelaram que 86 de 1.561 (5,5%) indivíduos tinham STC. Por outro lado, a STC subclínica teve uma prevalência combinada de 14% (30/215). A área de seção transversa do nervo mediano dos pacientes com AR sem STC foi semelhante à de controles saudáveis. A grande maioria dos estudos (8/13) não apresentou relação significativa entre os achados no nervo mediano e os parâmetros clínicos ou laboratoriais na AR. A ligação entre a AR e as anormalidades do nervo mediano foi excessivamente valorizada em toda a literatura. A prevalência de STC na AR é semelhante à da população em geral, sem qualquer correlação entre as características do nervo mediano e os parâmetros clínicos da AR.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Arthritis, Rheumatoid / Wrist Joint / Carpal Tunnel Syndrome / Median Nerve Type of study: Controlled clinical trial / Etiology study / Incidence study / Prevalence study / Prognostic study / Risk factors / Systematic reviews Limits: Humans Language: English Journal: Rev. bras. reumatol Journal subject: Rheumatology Year: 2017 Type: Article Affiliation country: Malaysia Institution/Affiliation country: Universiti Kebangsaan Malaysia/MY

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Full text: Available Index: LILACS (Americas) Main subject: Arthritis, Rheumatoid / Wrist Joint / Carpal Tunnel Syndrome / Median Nerve Type of study: Controlled clinical trial / Etiology study / Incidence study / Prevalence study / Prognostic study / Risk factors / Systematic reviews Limits: Humans Language: English Journal: Rev. bras. reumatol Journal subject: Rheumatology Year: 2017 Type: Article Affiliation country: Malaysia Institution/Affiliation country: Universiti Kebangsaan Malaysia/MY