Rheumatoid hand
From WikiLectures
- 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
