F-2-24-03
QUANTITATIVE ANALYSIS OF THEKMOGRAPHIC CHANGE IN HAND JOINTS WITH RHEUMATOID ARTHRITIS
Ichiro Watanabe, Rie Nakane, Takayo Chuma, Osamu Shirado and Yukio Mano (Hokkaido University, Sapporo, Japan)
There has been no good index to define the activities of rheumatoid arthritis patients. We have decided to know the severity of the disease according to subjective complaints, the hours of morning hand stiffness and grasping power score. In rheumatoid arthritis patients suffering from hand arithfitis, we administered the same anti-inflammatory drugs (indometacin farnesil) and measured thermographies of hands before and after four weeks of the drug therapy. In a 23℃ temperature 45% humidity controlled room, we applied cold water (23℃) bags to both hand joints for 30 seconds (cold-water immersion test), and recorded the thermographies for five minutes after the cold immersion.
After the cold-water test, the temperature of the active joint recovered more quickly than the healthy side. There were significant differences between the joint temperatures before and after therapy. Thermography is thus considered to be a useful method to indicate arthritic activity.
F-2-24-04
DIAGNOSTIC AND SURGICAL CONSIDERATIONS IN CARPAL TUNNEL SYNDROME
Oleh Maryniak (University of Western Ontario, London, Ont., Canada)
Yuri Marchuk (Kyiv Institute of Postgraduate Studies, Kyiv, Ukraine)
Purpose: To report on diagnostic accuracy and effect of surgery in carpal tunnel syndrome (CTS).
Methods: A clinical prediction was made on 105 consecutive patients referred to our laboratory with possible CTS. This prediction was compared with the subsequent EMG test result. Also, in 18 patients with very severe CTS (no motor and/or sensory response), the one-year post-surgical outcome was determined.
Results: The clinical prediction of CTS had unacceptably low sensitivity (67%) and specificity (55%). Surgery in severe CTS provided satisfactory results in 14 of 18 patients (78%). Conclusions: 1) Clinical diagnosis of CTS is not reliable. 2) Surgical release is helpful even in extremely severe CTS.
