To investigate the relation between joint involvement in the upper extremities and grip force in patients with early rheumatoid arthritis (RA). An inception cohort of 225 patients with early RA was followed according to a structured protocol. The same rheumatologist assessed all patients for swollen joints and joint tenderness. Grip force was measured (Grippit; AB Detektor, Gothenburg, Sweden) at the same visit. Average grip force values for the dominant hand were expressed as % of expected, based on age- and sex-specific reference values from the literature. Associations between grip force and current synovitis or tenderness of individual joints, and other disease parameters measured at the same visit, were examined. Patients with current synovitis of the wrist joint or ≥ 1 metacarpophalangeal (MCP) joint of the dominant hand had a significantly lower grip force at inclusion, at 1 year and at 5 years. Proximal interphalangeal joint tenderness and MCP joint tenderness were consistently associated with reduced grip force. In multivariate analysis, extensive MCP joint synovitis was associated with lower grip force at inclusion (β - 2.8% per joint; 95% CI - 5.3 to - 0.4), and also at the 1-year follow-up. Patient reported pain scores and erythrocyte sedimentation rates had independent negative associations with grip force at all time points. In patients with early RA, extensive synovitis of the MCP joints was associated with reduced grip force, independently of other upper extremity joint involvement. Pain and inflammation have effects on hand function beyond those mediated by local synovitis.

中文翻译：

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早期类风湿关节炎的上肢关节受累与握力之间的关系：一项回顾性研究。

调查早期风湿性关节炎（RA）患者上肢关节受累与握力之间的关系。根据结构化方案，对225例早期RA患者的初始队列进行了追踪。同一位风湿病医师对所有患者的关节肿胀和压痛进行了评估。在同一次访问中测量了握力（Grippit； AB Detektor，瑞典哥德堡）。基于文献中针对年龄和性别的参考值，优势手的平均握力值表示为预期的百分比。检查了抓力与当前滑膜炎或单个关节的压痛之间的关联，以及在同一次就诊时测得的其他疾病参数。当前手腕关节滑膜炎或优势手≥1个掌指关节（MCP）关节的患者在入选时，1年和5年时的握力明显降低。近端指间关节压痛和MCP关节压痛与抓握力降低相关。在多变量分析中，广泛的MCP关节滑膜炎在包涵时具有较低的抓地力（每关节β-2.8％； 95％CI-5.3至-0.4），并且在1年随访中。患者报告的疼痛评分和红细胞沉降率在所有时间点均与握力呈负相关。在患有早期RA的患者中，MCP关节广泛滑膜炎与抓地力降低相关，独立于其他上肢关节受累。