THE DISTRIBUTION OF RADIOLOGICAL JOINT DAMAGE IN THE RHEUMATOID HAND

We report a detailed study of the relative distribution of jointdamage, as assessed by erosion and joint space scores, in theproximal interphalangeal (PIP) and metacarpophalangeal (MCP)joints of the rheumatoid hand. Hand radiographs of 30 patientswith erosive rheumatoid arthritis were studied. There was significantly more damage in the dominant hand. Thelittle-finger PIP joints were more damaged and the thumb interphalangeal(IP) joints less damaged than the other PIP joints. The indexand middle finger MCP joints were more damaged than the otherMCP joints. There was a significant negative correlation betweenthe erosion scores of the PIP and MCP joints of each individualdigit, when digits with only minimal damage were excluded. These findings support the concept that joint damage in therheumatoid hand is greater in those joints that are subjectedto greater mechanical stresses, and that in any digital raythe damage is concentrated at either the PIP or MCP joint. ^*Paper read at the Annual Provincial Meeting of the BritishAssociation for Rheumatology and Rehabilitation, the Royal Societyof Medicine, Section of Rheumatology and Rehabilitation andthe Irish Society for Rheumatology and Rehabilitation, Portsmouth,12 and 13 October 1978.