Rheumatoid Arthritis in the Hands
Rheumatoid arthritis affects the cells that lubricate and line joints, causing the tissue (synovium) to become inflamed and swollen. The swollen tissue stretches the ligaments and the tendons, causing the joints to deform and become unstable. Joint cartilage and bone also erodes. Your knuckle may feel hot and look red. Rheumatoid arthritis in the hands most often occurs in the wrist and knuckles. The disease is symmetric, meaning what occurs in one hand usually occurs in the other.
Signs and Symptoms of Hand Rheumatoid Arthritis
While common arthritis symptoms such as stiffness, swelling, and pain may occur, the classic features of rheumatoid arthritis include:
- Firm nodules along fingers or the elbow
- Soft lump on the back of the hand that moves as the fingers straighten
- Angulation or collapse of fingers
- Sudden inability to straighten or bend a finger because of tendon rupture
- Deformity in which the middle finger joint becomes bent (Boutonniere deformity)
- Deformity where the end of the finger is bent and the middle joint over extends (Swan-neck deformity)
- Prominent bones in the wrist
You may also experience numbness and tingling in your hands (carpal tunnel syndrome) because the swelling of the tendons causes pressure on the adjacent nerve. They may make a squeaky sound as they move joints (crepitus), and sometimes the joints snap or lock because of the swelling.
How is Hand Rheumatoid Arthritis Diagnosed?
The doctor will perform a clinical examination, x-rays, and lab tests. He will also ask you questions about your symptoms and how the disease has affected your activities. Because Rheumatoid arthritis may have a hereditary component, he may ask if any family members suffer from similar symptoms.
The doctor will also complete a detailed examination of your hands. The appearance of your hands will help him diagnose the specific type of arthritis.
An x-ray may reveal characteristics of Rheumatoid arthritis including:
- Swelling of the non-bony structures
- Joint space narrowing
- Decreased bone density
- Erosions near joints
There are also several blood tests that can confirm the clinical diagnosis.
Hand Rheumatoid Arthritis Treatment
Treatment is designed to decrease inflammation, relieve pain, and maintain function. While there is no cure for rheumatoid arthritis, there are medications that slow the progression of the disease.
Hand therapy may help relieve pain and protect the joints. Exercises, splints, and adaptive devices can also help you cope with activities of daily living.
Rheumatoid arthritis can be a progressive disease. Surgical intervention may be necessary to maximize function and minimize deformity. In certain cases, the doctor may recommend preventative surgery which could include:
- Removing nodules
- Decreasing pressure on the joints and tendons by removing inflamed tissue
- Removing bone spurs that may rub on tendons or ligaments
Several types of procedures treat joints affected by rheumatoid arthritis including:
- Removal of inflamed joint lining
- Joint replacements
- Joint fusions
The procedure the doctor recommends will depend on many factors including which joint is involved, the degree of damage present, and the condition of surrounding joints.
If you’re suffering from hand rheumatoid arthritis, don’t hesitate to call South Florida Hand and Orthopaedic Center at (561) 241-4758.