THE OCCURRENCE AND SIGNIFICANCE OF HAND DEFORMITIES IN EARLY RHEUMATOID ARTHRITIS

One hundred rheumatoid arthritis patients (38 men, 62 women),with mean age of 53 years and mean disease duration of 11.5months, were followed. Standardized clinical, biochemical, andradiographic evaluation was performed regularly. After 2 yearsthe prevalence of ulnar deviation, buttonhole deformity, andswan neck deformity was 13%, 16%, and 8%, respectively. Altogether,31 patients had developed one or more deformities. There wasno difference in age or gender distribution and no predominanceof the dominant hand. Each patient with a deformity was matchedaccording to age, sex, and disease duration with another earlyRA patient without deformity. The deformity group had more activedisease, less grip strength, more disability, and markedly moresevere radiographic changes. When studied retrospectively ata time point 3 months prior to the detection of deformity, synovitisof relevant joints was as common in the group who developeddeformities as in the control group. This suggests that jointinflammation may contribute to the genesis of deformity butadditional factors are needed. Hand deformities were found tobe common in early RA. KEY WORDS: Early RA, Ulnar deviation, Swan neck deformity, Buttonhole deformity, Radiology, Hand disability