Rheumatoid hand

From WikiLectures

Rheumatoid arthritis - affected joints of the 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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