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Hand and Finger Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a painful inflammatory disease that causes swelling, stiffness, joint destruction, and deformity. This autoimmune disease has an effect on the cells that coat and lubricate joints (synovial tissue).

Osteoarthritis (the "wear and tear" arthritis") may often affect just one joint even though it can affect multiple joints. Rheumatoid arthritis, though, typically affects multiple joints and  usually happens symmetrically. For instance, RA may affect  the same joint group on both sides of the body.

What are the symptoms of hand and finger RA?

The wrist joints and the finger joints are common targets of RA. With hand and finger RA, you may experience the following:

  • Hand pain, finger pain, swelling, and stiffness
  • Hand joints and finger joints that are warm and tender to the touch
  • The same joints affected symmetrically (both wrists and fingers on both hands)
  • Deformities in finger joints
  • Carpal tunnel symptoms such as numbness and tingling of the hands
  • Flu-like feeling
  • Fatigue that is not easily resolved
  • Pain and stiffness that last for more than an hour upon arising

 

What causes RA?

Scientists are unsure about the causes of RA. They do know that RA affects about 1.3 million Americans and occurs in all racial and ethnic groups. About two to three times as many women suffer from rheumatoid arthritis as men. Some rheumatoid arthritis research points to the following factors as possibly influencing rheumatoid arthritis:

  • Genetic factors.
  • Environmental factors such as a viral or bacterial infection.
  • Hormones. RA tends to improve with pregnancy. Breastfeeding, and the postpartum period (the time after delivery), however, may aggravate rheumatoid symptoms.

 

What is a swan-neck deformity?

Rheumatoid arthritis is a common cause of a swan-neck deformity. 

With a swan-neck deformity, the base of the finger and the outermost joint bend, while the middle joint straightens. Over time, this imbalance of the finger joints can result in the crooked swan-neck position. (True swan-neck deformity does not occur in the thumb.)

A swan-neck deformity can make it almost impossible to bend the affected finger normally; it can make it difficult to button shirts, grip a glass, or pinch with the fingers.

By examining the hand and fingers, a rheumatologist can diagnose a swan-neck deformity and determine appropriate treatment, which may include:

  • Finger splints or ring splints
  • Surgery to realign the joints or fuse the joints for better function

 

What is a boutonniere deformity?

Boutonniere deformity, also called buttonhole deformity, can occur as a result of rheumatoid arthritis.

With a boutonniere deformity, the middle finger joint will bend toward the palm while the outer finger joint may bend opposite the palm. This deformity may be the result of chronic inflammation of the finger's middle joint.

Treatment for boutonniere deformity may include splinting to keep the middle joint extended. Surgery may be needed.

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