Rheumatoid hand


 *  Rheumatoid polyarthritis in the hand area: involvement synovia joint of the wrist, MCP and PIP + synovial tendon (systemic inflammatory disease affecting all synovial tissue),
 * hands deformed in shape (ulnar deviation of fingers + volar subluxation in MCP joints, flexion contractures of the thumbs, deformities such as swan neck or buttoned fingers), the disease was accompanied from the beginning by severe pain,
 * movement restricted gradually,
 * rheumatic wrist: pain localized to the ulnar head area - local synovectomy + extirpation of the ulna head leads to the disappearance of pain,
 * tendon sheaths involvement may precede months before symptoms of joint symptoms,


 * hypertrophic synovialis produces proteolytic enzymes → catabolic changes in the tendon,
 * tendon sheaths most often affected on the wrist and palm side of the fingers,
 * tendon ruptures may occur due to bone abrasion (mainly in the distal end of the ulna), direct invasion of the tenosynnovium on the tendon, ischemic necrosis,


 * MCP joints key to finger function
 * the damaged MCP joint is affected by wrist deformity, forces of flexors + extensors, dysbanlation of mm

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