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articular manifestations/deformities of rheumatoid arthritis (RA)
Clinical manifestations:
1) evidence of inflammation
a) joint tenderness
b) joints warm but no erythematous
c) swelling of synovium
2) symmetric small joint involvement
a) metacarpophalangeal joints, metatarsophalangeal joints
b) proximal interphalangeal joints
b) distal interphalangeal joints generally not involved
3) functional limitation
a) limited range of motion
b) decreased musclel strength & function around inflamed joints
4) Boutnonniere deformity of the finger
a) hyperextension of the distal interphalangeal joint
b) flexion of the proximal interphalangeal joint
5) swan-neck deformity of the finger
a) hyperextension at the proximal interphalangeal joint
b) flexion at the distal interphalangeal joint
6) ulnar deviation of the metacarpophalangeal joints
- may progress to complete volar subluxation of the proximal phalynx from the metacarpal head
7) compression of the carpal bones & radial deviation at the wrist & carpal bones
8) subluxation of the wrist
9) valgus deformity of the ankle & hindfoot
10) pes planus
11) forefoot varus deformity & hallux valgus
12) cock-up toes from subluxation at the metatarsophalangeal joints
Related
rheumatoid arthritis (RA)
References
- Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed)
Lippincott-Raven, Philadelphia, 1998, pg 823
- Medical Knowledge Self Assessment Program (MKSAP) 15,
American College of Physicians, Philadelphia 2009