Features of the course of occupational upper limb myofibrosis in patients with generalized polyosteoarthritis

Abstract

Introduction. Occupational diseases of the upper extremities from physical (functional) overstrain occupy a leading place in the structure of occupational morbidity, with myofibrosis being the most common disease. The aim of the study was to assess the course of myofibrosis against the background of generalized polyosteoarthritis using the ultrasound method. Materials and methods. One hundred seventeen mining industry workers were examined. The main group consisted of 20 patients with an established diagnosis of 1st stage of myofibrosis and generalized osteoarthritis, the control group consisted of 97 patients with an established diagnosis of 1st stage of myofibrosis. Standard clinical and laboratory methods of examination, ultrasound examination of the muscles of the forearms and shoulders were performed. Results. The median values of epimysium and muscle bundles thickness in both the main and control groups correspond to stage 1 of myofibrosis, while the median thickness of perimysium in the reference group corresponds to stage 1, and in main group it corresponds to stage 2. In addition, the 75th percentile of epimysium thickness, as well as the 25th percentile of muscle bundle thickness in the main group, also meet the criteria for stage 2 of myofibrosis. Limitations. The study has gender restrictions (men were investigated), as well as restrictions on professions (mining workers). Conclusions. According to the results of ultrasound examination, in the main group patients there are signs corresponding to the transition of myofibrosis to the second stage, which is characterized by a statistically significant increase in perimysium thickness, as well as a pronounced tendency of epimysium thickness increase and reduce of muscle bundle thickness. This is important when the disease is associated with occupation, allowing patients with a combination of myofibrosis and generalized osteoarthritis to establish a more severe stage of myofibrosis course, indicating a more pronounced degree of occupational work ability loss.