Carpal collapse in rheumatoid arthritis - Prevalence and clinical significance: A preliminary study

Objective. To evaluate the prevalence and clinical significance of carpal c ollapse in Mexican women with rheumatoid arthritis (RA). Methods. 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 functio nal class, characteristics and duration of the disease, and presence of rhe umatoid factor (RF). Results. CHR values of the controls were 0.49 +/-0.02 (values reported in A merican Caucasian women are 0.54 +/-0.04). Thirty-five patients had carpal collapse (defined as CHR less than or equal to 0.43) in the right hand, 30 in the left hand, and 23 bilaterally. Carpal collapse was associated with R F seropositivity and roentgenographic degree of progression (p<0.01), as we ll as with cumulative dose of steroids. As 95% of the patients were right-h anded, dexterity was not apparently affected. We observed no differences in Health Assessment Questionnaire, functional class, or disease duration bet ween patients with and those without carpal collapse. Conclusion. The definition of carpal collapse may have ethnic related diffe rences. Carpal collapse is common in Mexican women with RA and it is not an indicator of functional limitations.