Low-dose radiation therapy for hand osteoarthritis: shaking hands again?

BACKGROUND: Hand osteoarthritis (HOA) is one of the most common causes of pain and functional disability in western countries and there is still no definitive cure. Low-dose radiation therapy (LDRT) has anti-inflammatory properties that have shown to be effective in the symptomatic relief of various degenerative musculoskeletal disorders. We designed a clinical protocol using LDRT for symptomatic HOA and present results and tolerance in the first 100 patients included. MATERIALS AND METHODS: Between April 2015 and March 2021, 100 patients with a median age of 60 were treated. Fifty-seven patients suffering from proximal/distal interphalangeal joint pain, 40 patients with thumb arthritis, 2 patients with radiocarpal joint affection and 1 patient with metacarpophalangeal joint pain were enrolled. LDRT comprised of 6 fractions of 0.5-1 Gy on every other day up to a total dose of 3-6 Gy. Clinical response was evaluated according to the visual analog scale (VAS) for pain level and the von Pannewitz score (VPS) for joint functionality. Any patients not achieving subjective adequate pain relief after 8 weeks of treatment were offered a second identical LDRT course. RESULTS: With a median follow-up of 10.5 months (range 7.55-12.45), 94% reported an improvement in the pain, with a significant reduction in the VAS level after 3, 6 and 12 months (p < 0.001). Sixty-three patients needed a second course of treatment at a median time interval of 12 weeks (range 9-14). The mean VAS score before treatment was 8 (range 3-10). After treatment, it was 5 (range 1-10). After 3, 6 and 12 months, the mean VAS scores were 4 (range 0-9), 3 (range 0-9) and 3.5 (range 0-9), respectively. Seventy patients reported functionality improvements after LDRT according to the von Pannewitz score. No acute or late complications were observed. CONCLUSION: LDRT appears to be safe and useful for HOA and is associated with good rates of pain relief and functionality improvements. However, further studies are necessary to confirm these promising results.

Uso de dispositivos de assistência por indivíduo com osteoartrite de mãos / Use of assistive devices by individuals with hands osteoarthritis

[{"text": "Introdução: A osteoartrite de mãos é uma doença articular que acarreta dor, rigidez, deformidade e perda\r\nda mobilidade, gerando grande impacto funcional na vida das pessoas, por tornar as atividades comuns do dia a dia\r\ndifíceis e dolorosas, repercutindo negativamente na sua qualidade de vida. Dispositivos de assistência são estratégias\r\nutilizadas por terapeutas ocupacionais para o tratamento sintomático da osteoartrite de mãos. Objetivo: Identificar e\r\ndescrever dispositivos de assistência indicados para indivíduos com osteoartrite de mãos a partir de uma intervenção\r\ndo terapeuta ocupacional. Método: Estudo observacional, descritivo de corte transversal. Realizado em população\r\ndiagnosticada com Osteaoartrite de mãos, no ambulatório de terapia ocupacional de um hospital referência, no\r\nperíodo de agosto a setembro de 2015. Dezesseis participantes responderam a um questionário semiestruturado\r\nelaborado com enfoque na descrição e frequência de uso dos dispositivos de assistência indicados e ofertados em\r\numa pesquisa mestre. A análise de dados ocorreu por estatística descritiva através de medida de tendência central e\r\ndistribuição de probabilidade. Resultados: Os dispositivos de assistência utilizados no dia a dia dos 16 indivíduos\r\nentrevistados foram adaptadores para o vestir, adaptadores para o banho, descascadores, engrossadores, abridores e\r\ncortadores. Foram incluídos na rotina dos participantes 84% destes dispositivos de assistência com frequência diária,\r\nsemanal e mensal. Conclusão: Os dispositivos de assistência utilizados pela população estudada foram adaptadores\r\npara o vestir, adaptadores para o banho, descascadores, engrossadores, abridores e cortadores.", "_i": "pt"}, {"text": "Introduction: Hands osteoarthritis is a joint disease that causes pain, stiffness, deformity and loss of\r\nmobility. It has huge functional and negative impact on people's quality of life by making the common daily\r\nactivities difficult and painful. Assistive devices are strategies used by occupational therapists for the symptomatic\r\ntreatment hands osteoarthritis. Objective: To identify and describe assistive devices indicated for individuals with\r\nhands osteoarthritis through an Occupational Therapy intervention. Method: Cross-sectional study, conducted on\r\nsubjects diagnosed with hands osteoarthritis in an Occupational Therapy clinic at a reference hospital in the state,\r\nfrom August to September 2015. Sixteen participants answered a researcher-developed semi-structured questionnaire,\r\nfocusing on the description and frequency of use of specified assistive devices. Data were analyzed using descriptive\r\nstatistics through measure of central tendency and probability distribution. Results: The assistive devices used in the\r\ndaily lives of the 16 individuals interviewed were: adapters for dressing, adapters for bathing, peelers, thickeners,\r\njar/bottle openers and cutters. were in the routine of individuals 84% of these assistive devices with a daily, weekly\r\nand monthly frequency. Conclusion: In this study, individuals suffering from hand osteoarthritis used adapters for\r\ndressing, adapters for bathing, thickeners, peelers, jar/bottle openers and cutters as assistive devices.", "_i": "en"}]