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    Rheumatoid Hand 01.08.19

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    Rohit Theodore
    Rheumatoid arthritis is a chronic inflammatory disease that causes swelling and deformity in the joints of the hands. It is characterized by symptoms like morning stiffness, swelling, pain, and weakness in the hands. Examination reveals swollen finger joints, thickened tendons, limited mobility, and diminished grip strength. Radiographs show bone erosions and joint space narrowing. Differential diagnoses include other types of arthritis and connective tissue diseases that can present similarly.

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    Rheumatoid Hand 01.08.19

    Uploaded by

    Rohit Theodore
    13 views15 pages
    Rheumatoid arthritis is a chronic inflammatory disease that causes swelling and deformity in the joints of the hands. It is characterized by symptoms like morning stiffness, swelling, pain, and weakness in the hands. Examination reveals swollen finger joints, thickened tendons, limited mobility, and diminished grip strength. Radiographs show bone erosions and joint space narrowing. Differential diagnoses include other types of arthritis and connective tissue diseases that can present similarly.

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    Rheumatoid arthritis is a chronic inflammatory disease that causes swelling and deformity in the joints of the hands. It is characterized by symptoms like morning stiffness, swelling, pain, and weakness in the hands. Examination reveals swollen finger joints, thickened tendons, limited mobility, and diminished grip strength. Radiographs show bone erosions and joint space narrowing. Differential diagnoses include other types of arthritis and connective tissue diseases that can present similarly.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    13 views15 pages

    Rheumatoid Hand 01.08.19

    Uploaded by

    Rohit Theodore
    Rheumatoid arthritis is a chronic inflammatory disease that causes swelling and deformity in the joints of the hands. It is characterized by symptoms like morning stiffness, swelling, pain, and weakness in the hands. Examination reveals swollen finger joints, thickened tendons, limited mobility, and diminished grip strength. Radiographs show bone erosions and joint space narrowing. Differential diagnoses include other types of arthritis and connective tissue diseases that can present similarly.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 15

    Rheumatoid Hand

    Introduction
    • A disease of chronic polyarticular
    inflammation that leads to joint swelling, joint
    deformity and loss of joint function.

    • Prevalence varies depending on age, race, and


    classification criteria used.
    Clinical features
    • Joint stiffness- morning stiffness which
    improves with low grade activity
    • Swelling
    • Pain
    • Deformities
    • Constitutional symptoms
    • Subcutaneous nodules
    Examination
    • Swelling of the MCP and PIP joints giving the
    fingers a spindle shape
    • Both hands are affected, more or less
    symmetrically.
    • Swelling of tendon sheaths is usually seen on
    the dorsum of the wrist and along the ulnar
    border
    • Thickened flexor tendons felt on the volar
    aspect of the proximal phalanges.
    • The joints are tender and crepitus may be felt
    on moving the tendons.
    • Joint mobility and grip strength are
    diminished.
    Clinical features
    • Weakness: Rheumatoid hands are weak because
    of a combination of generalized muscular
    weakness, pain inhibition, tendon malalignment
    or rupture, joint stiffness and nerve compression.

    • Rheumatoid nodules:These are associated with


    aggressive disease in seropositive patients. They
    tend to occur at pressure areas (e.g. the pulps of
    the fingers and the radial side of the index
    finger).
    • Z-collapse: If one of two adjacent joints
    changes direction, then the overlying long
    tendons will pull the other joint into the
    opposite direction.
    In rheumatoid arthritis, this is typified by
    radial tilt of the wrist with ulnar drift of the
    MCP joints, the boutonnière deformity and
    the swan-neck deformity.
    Swollen fingers - differential diagnosis
    Always be on the alert for ‘lookalikes’.

    Rheumatoid Osteoarthritis Gout


    Radiological evaluation
    • Xrays
    a) b) c)
    Differential diagnosis
    • The differential diagnosis of RA includes:
    • Acute viral polyarthritis, such as rubella or parvovirus
    • SLE
    • Sjögren’s syndrome
    • Sarcoidosis
    • systemic immune complex reactions
    • reactive arthritis
    • psoriatic arthritis
    • polyarticular CPPD(pseudogout)
    • erosive osteoarthritis involving mainly the PIPs. All can have
    polyarthritis, but historical features of infection, cutaneous
    abnormalities, and patterns of joint involvement all suggest these
    alternate diagnoses.

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