Relationship between weakness and muscle wasting in rheumatoid arthritis

Abstract EN

This stutfy was carried out on 50 patients suffering from rheumatoid arthritis (RA) .

They were 42 females (84%) and 8 males (16%), with a mean age of 42.4 ± 12.8years .

A control group of 30 healthy subjects were also included.

All the patients were subjected to : 1- Full clinical examination including : Anatomical cross sectional area (CSA) of the Rt forearm, deformity index.

Ritchie index, grip strength, muscle grading and functional capacity .

2- Laboratory investigations : Rheumatoidfactor (RF), blood picture and ESR .

3- Radiological examination : Plain X-ray on both hands, Rt forearm for calculation of area of ulna and radius, Computed Tomography (CT) at Rt mid forearm to 10 subjects (8 patients and 2 controls) .

The mean anatomical CSA of RA patients was (25.08 ±3.7 cm2) and showed a high significant diffenence (P <0.

01) when compared to that of control group (29.51 ± 2.9 cm2) .

The mean grip strength in RA patients was (72.68 ± 20.6 mm Hg) and also showed a high significant difference (P <0.

01) when compared to that of control g oup (200 ± 14.38 mm Hg) .

The estimated CSA by anthropometric data correlated significantly to the actual CSA by CT.

(P < 0.05) and there was a highly significant correlation between the anatomical CSA and maximum grip strength .

Also significant correlation was found between anatomical CSA and deformity index (P < 0.0001), Ritchie index (P < 0.05), the mean age of onset (P < 0.0001), duration of disease (P < 0.05) and Rheumatoid Factor +ve patients .

From these results we concluded that in RA there is wasting of the muscles of the forearm which is correlated y.h'.H i,,the reduction in grip strength.

This reduction in grip strength ‘ can be attribittrH j joint deformity and pain leading to inhibition ofgrip directly and indirectly oy arthrogenous muscle inhibition.