Rheumatoid Arthritis Hand Deformity: Inevitable or Preventable?

Question: Rheumatoid Arthritis Hand Deformity: Inevitable or Preventable?

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

• rheumatoid nodules
• joint swelling
• joint stiffness
• ulnar drift / ulnar deviation
• contractures
• wrist subluxation
• other hand, finger, thumb, and wrist problems

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. For example, one of the more recognizable rheumatoid arthritis hand deformities occurs when the hand deviates to the ulnar (pinkie side). Also, a finger can lose function due to rupture of tendons. Once these deformities occur, they are not reversible medically and may require surgery.

• Arthritis Hand Photo Gallery
• What Can Be Done to Prevent Hand Deformity in Rheumatoid Arthritis?
• Rheumatoid Arthritis Hand (Illustration)

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 disability which often occurs 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 one of the TNF blockers including:

• Enbrel (etanercept)
• Remicade (infliximab)
• Humira (adalimumab)

• Early, Aggressive Arthritis Treatment For Newly Diagnosed Patients
• Methotrexate For Rheumatoid Arthritis
• The Facts Of DMARDs (Disease-Modifying Anti-Rheumatic Drugs)
• Enbrel, Remicade, And Humira - How Are The Drugs Similar And Different?

Drug Combinations

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

• Methotrexate and one of the TNF blockers
• Methotrexate, Plaquenil, and Azulfidine

• TNF Blockers (Enbrel, Remicade, Humira) - Test Your Knowledge
• Combination Treatment For Rheumatoid Arthritis

Related Resources: Joint Protection

• Joint Protection
• Arthritis Aids (Protective / Adaptive Equipment)

_{Dr. Zashin is clinical assistant professor at University of Texas Southwestern Medical School and an attending physician at Presbyterian Hospitals of Dallas and Plano. Dr. Zashin is author of Arthritis Without Pain - The Miracle Of TNF Blockers. The book is useful for anyone on one of the biologic drugs or considering the biologic drugs.}