Rheumatoid Arthritis Hand Deformity: Is It Inevitable? Can It Be Prevented?

Question: Rheumatoid Arthritis Hand Deformity: Is It Inevitable? Can It Be Prevented?

Hand deformities, joint problems, and damage caused by rheumatoid arthritis can include:

Can some rheumatoid hand deformities be prevented or are hand deformities inevitable for people diagnosed with rheumatoid arthritis?

Answer:

Rheumatoid Arthritis Hand Deformity

Deformities of the hands are a common but significant complication of rheumatoid arthritis. Some of these deformities include the hand deviating to the ulnar (pinkie side) and loss of function of a finger due to rupture of the tendons. Once these deformities occur, they are not reversible medically and may require surgery.

Surgery

Some of the indications for surgery include pain, limited function, cosmetic, as well as a way to prevent further injury to other joints.

Early Treatment

Early treatment of rheumatoid arthritis is the best way to control the disease and prevent deformity as well as the disability which often occurs to patients when joints get damaged.

Even at later stages of disease, there is evidence that treating patients with active disease may help. In early or mild disease, DMARDs (disease-modifying anti-rheumatic drugs) such as Plaquenil (hydroxychloroquine) and Azulfidine (sulfasalazine) may be effective.

Moderate To Severe Rheumatoid Arthritis

Moderate to severe rheumatoid arthritis typically requires treatment with potentially more effective DMARDs including methotrexate (Rheumatrex, Trexall) and Arava (leflunomide), or TNF blockers including:

Drug Combinations

In many cases two or even three DMARDs may be combined to help patients. Some common examples include:

Related Resources - Rheumatoid Arthritis Hand Deformity - Joint Protection

Related Resources - Rheumatoid Arthritis

Answer provided by Scott J. Zashin, M.D., clinical assistant professor at University of Texas Southwestern Medical School, Division of Rheumatology, in Dallas, Texas. Dr. Zashin is also an attending physician at Presbyterian Hospitals of Dallas and Plano. He is a fellow of the American College of Physicians and the American College of Rheumatology and a member of the American Medical Association. Dr. Zashin is author of Arthritis Without Pain - The Miracle Of Anti-TNF Blockers. The book is a must-have for anyone on one of the biologic drugs (Enbrel, Remicade, Humira) or considering the biologic drugs. Read my review of the book.