You’ve probably heard that some types of arthritis can lead to joint deformities. Hand deformities with rheumatoid arthritis are especially common, as there are 25 joints that can be susceptible to damage from the disease.
These deformities have a characteristic appearance and can affect the function of your hands and wrists by causing pain and a reduced range of motion.
An Overview of Rheumatoid Arthritis
What Does Arthritis in the Hand Look Like?
This gallery of pictures of arthritis in the hands can help you understand what arthritis in the hand looks like; however, you shouldn't wait until you have visible hand deformities before seeing your healthcare provider.
Note that many of these deformities are also related to disease which was present before the newer treatments for arthritis were approved. These deformities are becoming much less common with early treatment of rheumatoid arthritis (RA) and other forms of inflammatory arthritis.
The best treatment for hand arthritis caused by RA is often a combination of disease-modifying antirheumatic drugs (DMARDs) and tumor necrosis factor inhibitors (TNF blockers). This treatment has helped many people prevent hand deformities. Around half of those with RA are able to achieve remission, though it isn't always long term.
As you look at these pictures, you can see evidence of common arthritis issues, such as rheumatoid nodules, swelling, ulnar drift, contractures, and other problems.
Keep in mind that everyone is different. The ages and deformities present in these photos are not necessarily an indication of what the average person can expect. The degree of arthritis symptoms in the hands will vary widely from person to person.
48-Year-Old Female With RA (Left Hand)
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This photo shows evidence of damage caused by long-term rheumatoid arthritis which was present before the newer anti-arthritic drugs became widely available.
In addition to disease-modifying drugs, surgery may be used to correct damage that is interfering with function. The person in this image had carpal tunnel release surgery.
What joints are affected by rheumatoid arthritis?
The proximal interphalangeal (PIP) and metacarpophalangeal joints (MCP) of the hands and wrists are commonly affected by RA.
59-Year-Old Male With Osteoarthritis
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Osteoarthritis, like other forms of arthritis, can sometimes result in significant deformities.
This picture shows osteoarthritis in the hands and the contractures that can occur with long-standing arthritis. Though this man’s hand looks like he has had hand surgery, he has not, and contractures can appear as if surgery was performed.
18-Year-Old Female With Juvenile RA
This image is of the hand of an 18-year-old woman who was diagnosed with juvenile idiopathic arthritis at the age of 2. It’s important to note that there are several different forms of JIA which can have different symptoms.
In general, the prognosis for JIA is more favorable than that of arthritis in adults. Many people live fulfilling and enjoyable lives even with the symptoms of juvenile arthritis.
The image here demonstrates significant swelling along with some mild joint deformity. This person has not had hand surgery.
60-Year-Old Male With RA
The image here shows joint damage related to rheumatoid arthritis as well as scars from hand surgery. Inflammation of the tendons in the hands can result in a number of problems, such as trigger finger.
35-Year-Old Female With RA (Left Hand)
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This image shows common findings in early rheumatoid arthritis affecting the hands. Significant swelling is present but without significant deformity. (This person has not had hand surgery.)
35-Year-Old Female With RA (Right Hand)
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This image also shows findings consistent with early rheumatoid arthritis. Swelling is present along with early joint damage. (This person has not had hand surgery.)
47-Year-Old Female With RA (Left Hand)
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This image shows less swelling than in the above pictures of a woman with early rheumatoid arthritis. Rather, there is evidence of joint damage as well as contractures from a long-term disease. (This person has not had hand surgery.)
55-Year-Old Female With RA (Left Hand)
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This picture of arthritis in the fingers and hand shows extensive deformity with contractures caused by rheumatoid arthritis. The damage is most notable at the metacarpophalangeal joints (MCP joints)—the joints at the base of the fingers. (This person has not had hand surgery.)
55-Year-Old Female With RA (Left Hand)
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The image here depicts the palmar view of hand deformity and contractures caused by rheumatoid arthritis. Damage is often less evident with this view. (This person has not had hand surgery.)
22-Year-Old Female With RA
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The image here shows a 22-year-old woman who has been living with rheumatoid arthritis for six years. Swelling is noted as well as the beginning of joint deformity in both of her hands. (This person has not had hand surgery.)
22-Year-Old Female With RA
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This image gives a better view of early hand and wrist joint deformity related to rheumatoid arthritis. (This person has not had hand surgery.)
22-Year-Old Female With RA (Right Hand)
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This image allows a closer view of the joint damage and subsequent hand deformity in a young woman with rheumatoid arthritis. The damage involves both her proximal interphalangeal joints (PCP joints)—the middle joints of the fingers, and her distal interphalangeal joints (DIP) joints—the most distal joints of the fingers. (This person has not had hand surgery.)
50-Year-Old Female With RA
This image depicts what many people find surprising with rheumatoid arthritis. Although patients often cite improved appearance as a motivator for seeking surgery, rheumatologists and surgeons focus primarily on joint function rather than cosmetic appearance. Sometimes good function is present with even severe deformities (and vice versa).
Three hand surgeons declined to perform hand surgery because this person had no pain and has good grip strength and hand function.
44-Year-Old Male With RA
The small peripheral joints of the hands and wrists become involved with rheumatoid arthritis, leading to contractures and deformities. This image shows the number of different joints which may be affected.
This person has rheumatoid arthritis and had surgery—a wrist synovectomy (removal of inflamed synovial tissue) and tendon transfers involving both hands.
62-Year-Old Female With RA
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This image shows the degree of joint damage and deformity which can result from the cartilage loss and bone erosion common to rheumatoid arthritis. This type of damage is much more common with inflammatory arthritis (such as rheumatoid arthritis) than with osteoarthritis.
This photo also shows an example of the rheumatoid nodules that can occur in patients with rheumatoid arthritis. (This person did not have hand surgery.)
52-Year-Old Female With RA (Left Hand)
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This image shows the left hand of a 52-year-old woman with rheumatoid arthritis who required surgery.
She had surgery on her left hand twice for trigger finger release of her ring finger and had a tenodesis (a surgery that stabilizes a joint by anchoring a tendon to bone) of the left middle finger.
In addition, she had nodules removed from both the right and left thumbs and had bilateral carpal tunnel surgery.
52-Year-Old Female With RA (Right Hand)
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This image shows the other hand of the person in the preceding photo. In addition to the surgeries the woman had on her left hand, she had rheumatoid nodules removed from the right thumb and carpal tunnel surgery on both sides.
38-Year-Old Female With RA (Right Hand)
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This image of the Japanese woman’s right hand and wrist shows joint deformities and contractures, but she has not had surgery on this hand. Many people believe arthritis is a disease that affects older people only. However, there are more than 700,000 people with rheumatoid arthritis in Japan.
38-Year-Old Female With RA (Left Hand)
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This image shows the left hand of the same woman above. While her deformities and contractures are more severe (from a visual standpoint) in her right hand, it was only her left wrist which required surgery to maximize function.
50-Year-Old Female With RA
This image shows the small hand joint damage present in a woman diagnosed at the age of 45 with rheumatoid arthritis who is now 50. She has not had hand surgery.
44-Year-Old Male With RA (Right Hand)
This image reveals some of the damage to thumb and finger joints that are common with rheumatoid arthritis.
44-Year-Old Male With RA (Left Hand)
This image shows the other hand of a man with rheumatoid arthritis. His left hand here is an example of ulnar drift, a common deformity associated with rheumatoid arthritis.
Inflammation of the fourth and fifth metatarsals (hand bones) increases the risk of developing ulnar drift due to the increased mobility of these joints.
7-Year-Old Female With Polyarticular JRA
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This image shows the damage to the hands of a 7-year-old girl who was diagnosed with rheumatoid arthritis by a biopsy at the age of 10 months. The photo shows how the bone in the affected digit is actually larger than her other finger bones.
This child had two separate surgeries to release scar tissue which was causing the contracture.
7-Year-Old Female With Polyarticular JRA
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These images show the finger with a rheumatoid nodule developed by the same child with JRA.
61-Year-Old Female With RA
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People with rheumatoid arthritis have varying degrees of joint swelling related to their disease. It can be quite dramatic as in this example. This person has had carpal tunnel surgery on the left hand.
61-Year-Old Female With RA
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This image again shows the joint swelling in this woman with rheumatoid arthritis.
27-Year-Old Female With RA (Right Hand)
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The image here again reveals the common joint swelling and damage related to rheumatoid arthritis. This person has had no hand surgery.
47-Year-Old Female With RA
As with many of the images here, this image shows the swelling and joint deformity which is far too common in people with rheumatoid arthritis.
Early treatment of rheumatoid arthritis is the best way to control the disease and prevent RA-related hand deformities. Pain and stiffness are also associated with rheumatoid arthritis of the hands and must be managed.
Summary
Arthritis can cause visible deformities in the hands. Early and aggressive treatment of arthritis can make a difference not only in pain and stiffness but in your ability to function from day to day.
Although these pictures can help you understand what arthritis in the hand looks like, you should see your healthcare provider before your condition reaches this stage.