articular manifestations/deformities of rheumatoid arthritis (RA)

Clinical manifestations

• evidence of inflammation
  • joint tenderness
  • joints warm but no erythematous
  • swelling of synovium
• symmetric small joint involvement
  • metacarpophalangeal joints, metatarsophalangeal joints
  • proximal interphalangeal joints
  • distal interphalangeal joints generally not involved
• functional limitation
  • limited range of motion
  • decreased musclel strength & function around inflamed joints
• Boutnonniere deformity of the finger
  • hyperextension of the distal interphalangeal joint
  • flexion of the proximal interphalangeal joint
• swan-neck deformity of the finger
  • hyperextension at the proximal interphalangeal joint
  • flexion at the distal interphalangeal joint
• ulnar deviation of the metacarpophalangeal joints
  • may progress to complete volar subluxation of the proximal phalynx from the metacarpal head
• compression of the carpal bones & radial deviation at the wrist & carpal bones
• subluxation of the wrist
• valgus deformity of the ankle & hindfoot
• pes planus
• forefoot varus deformity & hallux valgus
• cock-up toes from subluxation at the metatarsophalangeal joints

Additional terms

• rheumatoid arthritis (RA)