‘The Wrist Joint’ in Rheumatoid Arthritis

Abstract

Hand function is dependent upon the stability of the wrist joint1. The wrist joint is thus a key joint of the upper limb, and must be pain-free for normal hand function and adequate strength of grip2. Wrist involvement is frequently characteristic of rheumatoid arthritis, with tenosinovitis of the wrist extensor tendons evident in the early stages of the disease3. Severe hand deformities with ulnar deviation of the metacarpo-phalangeal joints, subluxation of the carpals and ruptured tendons, are the result of extensive wrist disease. Rheumatoid disease of the wrist and its affect on progressive hand deformity has been the subject of numerous investigations4,5,6,7,8. The purpose of this paper is to review the literature on the rheumatoid wrist in view of the current occupational therapy practice of splinting the affected wrists for functional positioning and the prevention of further wrist deterioration.