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Hand and Finger Rheumatoid Arthritis

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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.

What's the treatment for RA in the hand and finger?

Treatment for rheumatoid arthritis is a multifaceted regimen that includes:

  • Medications
  • Rest and exercise
  • Splints and special arthritis aids that help take pressure off painful joints
  • Self-managing stress
  • Dietary changes, such as eliminating foods that may trigger inflammation and including foods that may help decrease inflammation, such as omega-3 fatty acids found in cold-water fish, vitamin D, and flax oil
  • Regular medical checkups
  • Physical therapy
  • Surgery to help restore function


Which medications are used to treat hand and finger RA?

Medications commonly prescribed for RA include:

Disease-modifying anti-rheumatic drugs (DMARDs). These drugs are used with NSAIDs and /or corticosteroids in low doses. DMARDs include:

Nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs may be over-the-counter or prescription strength.

Biologic response modifiers (also in the category of DMARDs); these are usually used with methotrexate. Biologic agents include:

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