Metacarpophalangeal arthropathy associated with manual labor (missouri metacarpal syndrome). clinical, radiographic, and pathologic characteristics of an unusual degenerative process

Williams, William V.; Cope, Ray; Wd, Gaunt; Eh, Adelstein; Ts, Hoyt; Singh, Ashutosh Kumar; Ta, Pressly; R, English; Hr, Schumacher; Se, Walker

doi:10.1002/art.1780301207

Cited by 37 publications

(20 citation statements)

References 33 publications

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“…Although studies have shown that OA at the thumb base is highly heritable in whites (4), both the thumb base and the MCP joints are also susceptible to large lever arm forces during power grip (25). Several studies have shown that OA in the MCP joints is associated with jobs that often require power grip (26,27). In a longitudinal study, Chaisson et al found that the association between grip strength and incident OA is stronger in the MCP joints than in more distal joints, especially among women (25).…”

Section: Discussionmentioning

confidence: 99%

Lower prevalence of hand osteoarthritis among Chinese subjects in Beijing compared with white subjects in the United States: The Beijing Osteoarthritis Study

Zhang

Nevitt

et al. 2003

Arthritis & Rheumatism

121

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Objective. Fewer Chinese subjects in Beijing have hip osteoarthritis (OA) compared with whites in the United States, but as many or more Chinese subjects have knee OA. If these differences are due to a systemic predilection for disease, then the prevalence of hand OA, the best indicator of generalized disease, should be different in China. The goals of this study were to estimate the prevalence of hand OA among elderly Chinese in Beijing, and to compare it with that among elderly whites in the United States.Methods. We recruited a random sample of Beijing residents ages >60 years. Subjects answered questions on joint symptoms and provided posteroanterior radiographs of the hand. The protocol was identical to that used in the Framingham, Massachusetts OA Study. The hand radiographs from the Beijing OA Study were read intermingled with films from the Framingham OA Study. We defined a hand joint as having radiographic OA if it had a Kellgren and Lawrence grade >2. Symptomatic OA was present when both radiographic OA and self-reported pain were present in the same joint. We classified a subject as having radiographic or symptomatic hand OA if at least 1 hand joint had radiographic or symptomatic OA. We estimated the prevalence of hand OA in elderly subjects in Beijing and compared it with the prevalence of hand OA in elderly subjects from Framingham, using an age-standardized prevalence ratio.Results. We obtained both symptom information and hand radiographs from 2,525 subjects. Despite the older age of the group, only 44.5% of men and 47.0% of women had radiographic hand OA. Symptomatic hand OA occurred in 3.0% of men and 5.8% of women. Compared with white men in Framingham, the Beijing Chinese men had a much lower prevalence of radiographic hand OA (age-adjusted prevalence ratio 0.64, 95% confidence interval [95% CI] 0.58-0.70) and symptomatic hand OA (age-adjusted prevalence ratio 0.25, 95% CI 0.16-0.34). The proportion of multiple hand joints affected by OA in Chinese men was also significantly lower than in white men. A similar magnitude of difference was also observed in the women. However, prevalence of symptomatic OA at the metacarpophalangeal (MCP) joints in Chinese men and prevalence of radiographic OA at the MCP joints in Chinese women were similar to those in their white counterparts in Framingham.Conclusion. Elderly Chinese subjects in Beijing had a much lower prevalence of hand OA than did elderly whites in Framingham, Massachusetts. Coupled with the exceedingly low prevalence of hip OA in China, these results may suggest that the overall predilection for OA is less among subjects in China than among whites in the United States.Using a uniform definition of osteoarthritis (OA) across populations, we recently reported that elderly

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Section: Discussionmentioning

confidence: 99%

Lower prevalence of hand osteoarthritis among Chinese subjects in Beijing compared with white subjects in the United States: The Beijing Osteoarthritis Study

Zhang

Nevitt

et al. 2003

Arthritis & Rheumatism

121

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“…9,18,19 The primary purpose of this article was to present a case of MCP joint OA associated with a manual labor occupation and, in doing so, familiarize chiropractors with the so-called Missouri metacarpal syndrome. 15 This article also serves to remind the chiropractic physician of the key differentials of MCP arthropathy, namely, hemochromatosis and CPPD crystal deposition disease.…”

Section: Discussionmentioning

confidence: 99%

“…Only a few other studies describing similar cases were found in PubMed. [15][16][17] In a case series by Williams et al, 15 all 7 patients studied were male manual laborers (farmers, truck drivers, heavy machine operators, and a mason). Their ages ranged from 51 to 72 years, and all had engaged in heavy labor involving their hands for between 31 to 50 years.…”

Section: Manual Labor Mcp Arthropathymentioning

confidence: 99%

“…14 An occupational OA involving the MCP joints has also been described in manual laborers. [15][16][17] This disorder-thought to be from heavy work involving sustained gripping with both hands-has been termed the Missouri metacarpal syndrome. 15 Presented here is the first such case to be described in the chiropractic literature.…”

Section: Introductionmentioning

confidence: 99%

“…[15][16][17] This disorder-thought to be from heavy work involving sustained gripping with both hands-has been termed the Missouri metacarpal syndrome. 15 Presented here is the first such case to be described in the chiropractic literature. A discussion on the importance of making this diagnosis and ruling out its differentials is also included in this report.…”

Section: Introductionmentioning

confidence: 99%

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Manual labor metacarpophalangeal arthropathy in a truck driver: a case report

Emary¹

2010

Journal of Chiropractic Medicine

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Objective: The purpose of this study is to present an unusual and rarely described case of occupational hand arthropathy involving the metacarpophalangeal (MCP) joints. Clinical Features: A 62-year-old male truck driver (of 35 years) presented to a chiropractic clinic with pain and stiffness along the third metacarpal and MCP joint of the left hand. Examination revealed severe pain and limited flexion at the third MCP joint. Bilateral radiographs demonstrated severe osteoarthritis (OA) of this joint in the left (nondominant) hand and mild-to-moderate (asymptomatic) OA in the same joint on the right. Results of laboratory blood tests were unremarkable for metabolic, inflammatory, or infectious joint disease. Intervention and Outcome: The patient was diagnosed with bilateral, third MCP joint OA associated with manual labor. He was treated unsuccessfully with a short course of low-level laser therapy, MCP joint mobilization, and hand-stretching exercises. After 3½ years, the patient continues to work despite ongoing and worsening symptoms. Three serial left hand radiographs are presented, highlighting the progressive nature of this arthropathy. Conclusion: The differential diagnosis in patients presenting with manual labor MCP joint OA should include hemochromatosis and calcium pyrophosphate dihydrate crystal deposition disease. Because of the increased risk of serious systemic disease, it is imperative that these latter 2 disorders are ruled out before the former is diagnosed.

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Metacarpophalangeal Joint Impairment in Hand Osteoarthritis and Its Association With Mechanical Factors: Results From the Digital Cohort Osteoarthritis Design Hand Osteoarthritis Cohort

Kouki

Tuffet

Crema

et al. 2022

Arthritis Care & Research

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Objective: To determine the prevalence, distribution and characteristics associated with radiographic metacarpophalangeal (MCP) osteoarthritis (OA).Methods: This is a cross-sectional study of baseline data from the DIGItal Cohort Osteoarthritis Design, a French monocentric cohort including patients with symptomatic hand OA (HOA). We evaluated the prevalence of radiographic MCP OA defined as ≥2 MCP joints with a Kellgren and Lawrence score ≥2. We compared the prevalence of MCP OA in the dominant and non-dominant hands. Associations between radiographic MCP OA and patient characteristics were studied using univariable and multivariable logistic regression.Results: Radiographic MCP OA was present in 138 of the 425 patients (32.5%) but was not severe. Patients with MCP OA had a mean age of 69.2±6.9 years, a BMI of 25±4.2 kg/m 2 , and 86.2% were women. MCP OA was more frequent in the dominant hand and predominated at the 1st and 2nd MCP joints. In the multivariable analysis, MCP OA was associated with older age (OR 1.05, 95%CI [1.01,1.10] for each year), manual occupation (OR 3.74, 95%CI [1.21,11.54]), scaphotrapezial OA (OR 2.18, 95%CI [1.27,3.72]), and a high number of proximal interphalangeal joints with radiographic OA. MCP OA was not associated with metabolic syndrome or HOA symptoms. Conclusion:In this cross-sectional study using a hospital-based HOA cohort, radiographic MCP OA was frequent and associated with structural HOA features rather than with symptom severity. Our results suggest that the involvement of MCP joints in HOA is predominantly related to mechanical rather than systemic factors in this population.

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Metacarpophalangeal arthropathy associated with manual labor (missouri metacarpal syndrome). clinical, radiographic, and pathologic characteristics of an unusual degenerative process

Cited by 37 publications

References 33 publications

Lower prevalence of hand osteoarthritis among Chinese subjects in Beijing compared with white subjects in the United States: The Beijing Osteoarthritis Study

Lower prevalence of hand osteoarthritis among Chinese subjects in Beijing compared with white subjects in the United States: The Beijing Osteoarthritis Study

Manual labor metacarpophalangeal arthropathy in a truck driver: a case report

Metacarpophalangeal Joint Impairment in Hand Osteoarthritis and Its Association With Mechanical Factors: Results From the Digital Cohort Osteoarthritis Design Hand Osteoarthritis Cohort

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