Comment on Ryan et al., an investigation of association between chronic musculoskeletal pain and cardiovascular disease in the Health Survey for England (2008)

摘要

Objective: The purpose of this study was to evaluate the association between distal ulnar morphology and extensor carpi ulnaris (ECU) tendon pathology. Materials and methods: We retrospectively reviewed 71 adult wristMRI studies with ECU tendon pathology (tenosynovitis, tendinopathy, or tear), and/or ECU subluxation. Subjects did not have a history of trauma, surgery, infection, or inflammatory arthritis. MRI studies from 46 subjects without ECU tendon pathology or subluxation were used as controls. The following morphological parameters of the distal ulna were measured independently by two readers: ulnar variance relative to radius, ulnar styloid process length, ECU groove depth and length. Subjects and controls were compared using Student's t test. Inter-observer agreement (ICC) was calculated. Results: There was a significant correlation between negative ulnar variance and ECU tendon pathology (reader 1 [R1], P=0.01; reader 2 [R2], P<0.0001; R1 and R2 averaged data, P<0.0001) and ECU tendon subluxation (P=0.001; P=0.0001; P<0.0001). In subjects with ECU tendon subluxation there was also a trend toward a shorter length (P=0.3; P <0.0001; P=0.001) and a shallower ECU groove (P=0.01; P=0.03; P=0.01; R1 and R2 averaged data with Bonferroni correction, P=0.08). ECU groove depth (P=0.6; P=0.8; P=0.9) and groove length (P=0.1; P=0.4; P=0.7) showed no significant correlation with ECU tendon pathology, and length of the ulnar styloid process showed no significant correlation with ECU tendon pathology (P=0.2; P=0.3; P=0.2) or subluxation (P=0.4; P=0.5; P=0.5). Interobserver agreement (ICC) was >0.64 for all parameters. Conclusion: Distal ulnar morphology may be associated with ECU tendon abnormalities.