Original article Hand involvement in Behçet’s disease Merih Yurtkuran a, * , Mustafa Yurtkuran b , Alev Alp c , Koncuy Sivrioglu d , Kamil Dilek e , Feyzi Tamgaç f , Eray Alper f , Şükran Tunalı g , Hayriye Sarıcaoğlu g ,Aşkın Nasırcılar h a Division of Rheumatology, Atatürk Rehabilitation Center, Uludag University, Kükürtlü C.98, 16080 Bursa, Turkey b Department of Internal Medicine, Division of Nephrology, Kükürtlü C.98, 16080 Bursa, Turkey c Atatürk Rehabilitation Center, Uludag University, Kükürtlü C.98, 16080 Bursa, Turkey d Department of Physical Therapy and Rehabilitation, Uludag University, Kükürtlü C.98, 16080 Bursa, Turkey e Department of Internal Medicine, Division of Rheumatology, Kükürtlü C.98, 16080 Bursa, Turkey f Department of Nuclear Medicine, Kükürtlü C.98, 16080 Bursa, Turkey g Department of Dermatology of Uludag University Medical Faculty, Kükürtlü C.98, 16080 Bursa, Turkey h Atatürk Rehabilitation Center, Uludag University, Kükürtlü C.98, 16080 Bursa, Turkey Received 24 August 2005; accepted 4 November 2005 Available online 15 March 2006 Abstract Aims: To study the clinical hand findings in Behçet’s disease (BD) and to observe scintigraphic changes of these areas. Methods: Fifty-seven randomly selected BD patients and the patients in the control group (N = 40) were evaluated by two blind rheumatol- ogists. The hands were examined for the presence of pain, tenderness, swelling, effusion, erythema, warmth, range of motion and limitation of motion, deformities and muscle atrophy. Then scintigraphic examination of the hands was performed. Control hand scintigrams were obtained from 40 age- and sex-matched patients and were examined by the same two observers. Results: Thirty-two of the 57 patients (56.1%) showed Behçet’s clinical hand findings. Terminal phalangeal pulp atrophy was observed in 17 (29.81%), rheumatoid-like hand findings were observed in 16 (28.1%), dorsal interosseos atrophy was observed in 12 (20.05%) and erythema over the digits was observed in 12 (20.05%). Twenty-four patients (42.1%) had scintigraphic involvement. The disease duration was observed to be an important factor for hand findings (P = 0.040) and scintigraphic involvement (P = 0.011). Conclusion: High prevalence of hand involvement in BD and its relationship with disease duration is demonstrated. Hand involvement tends to be overlooked and careful examination is required in the evaluation of BD. The scintigraphic involvement detected in hands requires special consideration, too. © 2006 Elsevier Masson SAS. All rights reserved. Keywords: Behçet’s disease; Hand; Scintigraphy 1. Introduction Behçet’s disease (BD) is a systemic vasculitis of unknown cause with mucocutaneous, frequent ocular and musculoskele- tal involvement which is characterized by highest prevalence in Turkey, Iran and Japan [1,2]. It is commonly seen around the Mediterranean Sea and along the ancient ‘Silk Road’ in places such as Turkey, Iran, Korea and Japan. The prevalence of the disease is reported to be 1:250 to 1:1000 in Turkey and 0.1:100 000 to 0.6:100 000 in the USA and northern Europe [3,4]. It is reported that about 40–50% of the patients will be found to have synovitis [2,3,5]. It has been suggested that monoarticular or oligoarticular, non-deforming and self-limiting involvement is seen most commonly affecting the knees, ankles, wrists and elbows [2]. However, the joint involvements of BD are overshadowed by the more severe involvement of other systems. Scintigraphy is accepted as an extremely useful adjunctive diagnostic study to conventional radiography and may confirm the presence of the disease, illustrate the distribution of disease, and determine the activity of the disease present [6]. Möttönen http://france.elsevier.com/direct/BONSOI/ Joint Bone Spine 73 (2006) 679–683 * Corresponding author. Tel.: +90 0224 234 7691; fax: +90 0224 234 7690. E-mail address: merihcan@hotmail.com (M. Yurtkuran). 1297-319X/$ - see front matter © 2006 Elsevier Masson SAS. All rights reserved. doi:10.1016/j.jbspin.2005.11.008