Background: The chronic nature of rheumatic diseases leads to a negative impact on the quality of life. The upper limb is the target of multiple inflammatory and non-inflammatory rheumatic diseases ranging from painful syndromes to clear arthritis that differ in their pathophysiological mechanisms. Tools such as the DASH questionnaire measure the dysfunction of the thoracic extremity more objectively as a single unit. Functionality largely depends on the patient’s perception, and there’s uncertainty about whether the degree of disability of the upper extremity differs between patients with inflammatory rheumatic diseases and non-inflammatory ones.

Objectives: To compare the severity of upper extremity dysfunction among patients with inflammatory and non-inflammatory rheumatic diseases to determine if there’s a difference in the priority of early rehabilitation care.

Methods: Patients were recruited from the Rheumatology Clinic of the ‘Dr. José Eleuterio González’ University Hospital in Monterrey, N.L. Patients with inflammatory or non-inflammatory rheumatic diseases were included without distinction, and they underwent the DASH survey to assess the severity of upper limb dysfunction. Patients with a score >40 were classified with severe upper limb disability and were referred to the Rehabilitation Medicine Clinic. A division was made between patients with inflammatory and non-inflammatory rheumatic diseases, and their demographic characteristics were compared, as well as the results of their assessments through the DASH survey. This was done using the chi-square test for categorical variables and the t-student test for continuous variables. Additionally, the proportion of patients with severe dysfunction who therefore required referral to rehabilitation medicine was compared. A p-value ≤ 0.05 was considered statistically significant.

Results: Ninety-five patients were assessed, the majority being women (92.3%), with a mean age of 52 years (SD ± 12.4). They were divided into patients with inflammatory rheumatic disease (mainly rheumatoid arthritis) and non-inflammatory rheumatic disease (mainly osteoarthritis and fibromyalgia), comprising 70 and 25 patients, respectively. When comparing the results of the DASH survey, no statistically significant differences were found between patients with inflammatory and non-inflammatory rheumatic diseases (24.51 vs 24.48, p = 0.99, respectively). When comparing the proportion of patients classified with severe upper limb disability, no difference was found between the two groups (inflammatory: 24% vs non-inflammatory: 30%, p = 0.56).

Conclusion: It could be assumed that patients with inflammatory rheumatic diseases have greater upper limb disability due to more aggressive pathophysiological mechanisms, such as increased circulation of proinflammatory cytokines and autoantibodies. However, this study demonstrated that patients with non-inflammatory rheumatic diseases exhibit very similar proportions of severity when compared to their counterparts. These results show us that both groups require the same priority for screening to detect and refer promptly to an upper limb rehabilitation program.

REFERENCES: [1] Jester, A., Harth, A., Wind, G., Germann, G., & Sauerbier, M. Disabilities of the arm, shoulder, and hand (DASH) questionnaire: Determining functional activity profiles in patients with upper extremity disorders. Journal of hand surgery. 2005, 30(1), 23–28.

Acknowledgements: NIL.

Disclosure of Interests: None declared.