Hand deformity in rheumatoid arthritis and its impact on the quality of life

Abstract

Objective: For the purpose of this study, we assessed the frequency of hand deformities in rheumatoid arthritis (RA) as well as the impact of these deformities on the quality of life of the patients. Method: A group of 87 consecutive patients who had been admitted to the Department of Physical Medicine and Rehabilitation of our University Hospital between 2000 and 2002 were included in the study. 66 (76%) were females and, 21 (24%) were males with definite or classical RA. Patients who had undergone articular surgery or had warm and swollen joints were excluded. A protocol was designed to record age, dominant hand, duration of disease, and results of the physical examination. Hand disability was assessed by using a special hand disability index, which was composed by seven items. Result: There was hand deformity in 71 (81.5%) patients. The most common hand deformity was flexor tenosynovitis (64.5%). The other deformities were ulnar deviation (39.5%), boutonniere deformity (29.5%) and swan neck deformity (27.5%). There was a significant correlation between severity of the hand deformity, and disability index and disease duration. All patients were right handed but there was no significant difference between the right and the left hand of the patients regarding either the number of deformities or the grip strength. Eighty-one (93%) of the patients had hand disability. Hand disability was mild in 44%, moderate in 46%, and severe in 10%. Conclusion: RA is an important disease that can cause functional disabilities. Therefore, understanding these deformities is necessary for the proper management of these patients to improve their quality of life. This study is representative for the RA related hand deformities and quality of life of the patients in this country.