Rheumatoid arthritis of the hand and wrist

Abstract

♦ RA is common♦ Medical treatment is the mainstay and newer anti-TNF drugs are reducing morbidity and thus referral for surgery♦ Assessment is primarily clinical♦ Investigations – Primarily radiographs♦ Treatment• Non-operative• Steroid injections are often very useful• Operative• Site and condition specific♦ In general• DRUJ – excision ulna head• Wrist – partial fusion, arthrodesis, arthroplasty• MP joints – synvestomy, arthroplasty• PIP joints – soft tissue rebalancing, arthrodesis• DIP joints – arthrodesis• Thumb MP and IP joints – arthrodesis