Instability of the extensor digitorum tendons in Jaccoud arthropathy assessed by semi-dynamic MRI of the metacarpophalangeal joints - 24/04/21

Doi : 10.1016/j.diii.2021.03.005

Thomas Kirchgesner ^a,⁎ , Maria Stoenoiu ^b, Nicolas Michoux ^a, Xavier Libouton ^c, Frédéric Houssiau ^b,^{^{1
Bruno Vande Berg and Frédéric Houssiau equally contributed to this work.}}, Bruno Vande Berg ^a,^{^{1
Bruno Vande Berg and Frédéric Houssiau equally contributed to this work.}}
^a Department of Medical Imaging, Musculoskeletal Imaging Unit, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Institut de Recherche Expérimentale et Clinique (IREC), 1200 Brussels, Belgium
^b Department of Rheumatology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Institut de Recherche Expérimentale et Clinique (IREC), 1200 Brussels, Belgium
^c Department of Orthopedic Surgery, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Institut de Recherche Expérimentale et Clinique (IREC), 1200 Brussels, Belgium

^⁎Corresponding author.

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Saturday 24 April 2021
Cet article a été publié dans un numéro de la revue, cliquez ici pour y accéder

Highlights

•	Jaccoud arthropathy in patients with systemic lupus erythematosus is associated with instability of the extensor digitorum tendons in flexion.
•	Jaccoud arthropathy in patients with systemic lupus erythematosus is associated with some instability of the extensor digitorum tendons in extension.
•	Semi-dynamic MRI with flexed metacarpophalangeal joints helps to detect tendon instability.

Le texte complet de cet article est disponible en PDF.

Abstract

Purpose

The purpose of this study was to test the hypothesis that Jaccoud arthropathy (JA) in patients with systemic lupus erythematosus (SLE) is associated with instability of the extensor digitorum (ED) tendons during flexion of the metacarpophalangeal (MCP) joints by comparing the position of the ED tendons between SLE patients with JA and control subjects on hand MRI obtained with flexed and extended MCP joints.

Materials and methods

Thirty-two hands of SLE patients with JA (13 women and 3 men; mean age, 50.0±12.2 [SD] years; age range: 26–68years) and 24 hands of sex- and age-matched control subjects (20 women and 4 men; mean age, 50.1±13.0 [SD] years; age range: 24–68years) were included in the study. Axial spin echo T1-weighted MRI images of the second to fifth MCP joints in flexion and in extension were obtained. Two radiologists (R1 and R2) separately measured the amplitude and assessed the direction of the displacement of the ED tendons with respect to the midline at the level of each MCP joint. Statistical analysis included two-way ANOVA with random effects to assess differences in amplitude and Fisher–Freeman–Halton exact test to assess differences in direction with P-values<0.0083 and<0.0063 considered as statistically significant respectively.

Results

Amplitude of the displacement of the ED tendons was statistically significantly greater in SLE patients with JA than in control subjects in flexion for both readers (median 58°, 95% confidence interval [CI]: 50°–65° vs. 20°, 95% CI: 16°–24°; P<0.0001 for R1 and 54°, 95% CI: 47°–61° vs. 25°, 95% CI: 22°–28°; P<0.0001 for R2) and in extension for one reader (17°, 95% CI: 15°–20° vs. 14°, 95% CI: 11°–16°; P=0.0048 for R1 and 20°, 95% CI: 15°–25° vs. 16°, 95% CI: 12°–18°; P=0.0292 for R2). Ulnar deviation of the ED tendons was statistically significantly more frequent in SLE patients with JA than in control subjects in flexion and in extension for both readers (P<0.0001).