Compression Test (Gaenslen's Squeeze Test) Positivity, Joint Tenderness, and Disease Activity in Patients With Rheumatoid Arthritis

Abstract

Objective. Gaenslen's test (GT) positivity is characterized by tenderness upon lateral compression (squeezing) of the metacarpophalangeal (MCP) or metatarsophalangeal (MTP) joints. We aimed to assess the factors related to a positive GT and to explore differences in disease activity between GT-positive and -negative patients. Methods. The GT was performed routinely in outpatients with rheumatoid arthritis (RA). In total, 229 patients had a positive GT (GT-positive group). To this group, we matched a GT-negative group (n ‫؍‬ 222) comparable in sex, age, disease duration, and rheumatoid factor (RF) positivity. Disease activity scores, swollen and tender joint counts, patient pain and global assessments, evaluator's global assessment, morning stiffness, disability assessments, acute phase reactants, RF, and anti-citrullinated protein antibody levels were assessed and used for correlation analyses. A comparison between the GT-positive and -negative groups was performed and a regression model was calculated. Results. All clinical variables, including disease activity scores, joint counts, and disability assessments, were significantly higher in the GT-positive group than the GT-negative group. Also, there were significantly fewer patients in remission or with low disease activity in the GT-positive group. GT positivity correlated most strongly (r > 0.5) with joint tenderness (32-and 28-joint counts). Tender proximal interphalangeal, MCP, and MTP joints appeared mostly responsible for a positive GT, but more than 1 MCP/MTP joint had to be tender to explain a positive GT. Conclusion. The GT is related primarily to tenderness in MCP and MTP joints and signifies a moderate to high disease activity among patients with RA.

Effect of a thin customized insole on pain and walking ability in rheumatoid arthritis: A randomized study

“…The study included 21 subjects recruited consecutively from the outpatient clinic and the inpatient ward of a hospital for rheumatic diseases during the period May 2011 to December 2012 (Figure ). The inclusion criteria were: a definite diagnosis of RA (Britsemmer, Gerritsen, Ursum, van Tuyl, & van Schaardenburg, ), ≥18 years of age, foot pain on walking, and pain in at least one forefoot when assessed for affliction of the MTP joints using the Gänslen test (Wiesinger, Aletaha, Smolen, & Stamm, ). The Gänslen test was performed at the time of recruitment and immediately before the walking tests.…”

Diagnostic values of DAS28 and DAS28-squeeze in evaluating Rheumatoid Arthritis disease

“…1,5,6 Literatures stated that up to 40% patients classified as remission by DAS28 still have feet complaints (swollen and/or tender on at least one metatarsophalangeal [MTP] joint). 1,8,10,11 Further, remission patients, according to DAS28, were also found to have a significant swollen joint counts. 1,8,10,11 Feet complaints as an initial symptoms has been found in 60% of RA patients, and after 2 years the feet involvement prevalence decreases to 36%.…”

The specialist physician’s approach to rheumatoid arthritis in South Africa

“…This will result in earlier timeous referrals to specialists to initiate DMARDs ( Table 2 ) [ 17 , 18 ]. Efforts should be made to increase awareness amongst primary carers of the early signs of inflammatory arthritis (positive squeeze test of hands and/or feet with joint stiffness after immobility) [ 19 ].…”