Swan-Neck and Boutonniere Deformity in Rheumatoid Hand.

Abstract

Rheumatoid arthritis (RA) is an inflammatory disease for which the exact cause is unknown. It is an autoimmune disorder that primarily affects such joints which allows free movement in different directions, but also has many other severe complications related to mortality. On the other hand, this disease is responsible for digital deformities, arising out of a combination of synovitis, intrinsic muscles, and extrinsic tendons impairment, ligament rupture, joint dislocation, and final ankylosis. Articular swelling due to synovial proliferation is the first manifestation, but later deformity, subluxation, instability, contracture, and ankyloses can be visible with joint degeneration. Rupture of the capsular and tendon often happens at the wrist. Intrinsic and extrinsic muscle contractures are associated with typical hand joint malalignment. Osteoarthritic involvement has changed with the introduction of biologic disease-modifying anti-rheumatic drugs (bDMARD).