Assessment of Progressive Hand and Wrist Deformities in the Rheumatoid Patient

This article focuses on hand and wrist deformities arising from rheumatoid arthritis. The pathogenesis is synovitis and pannus formation, leading to direct tissue invasion and mass effect resulting in stretching and attenuation of ligaments. The typical deformity of a rheumatoid wrist is a dorsal subluxation of the ulna head (or more aptly, volar translation of the radius given that the ulna is fixed in position), with volar subluxation, ulnar translocation and supination of the carpus, eventually leading to carpal collapse. For each of these deformities, the pathogenesis is discussed, along with their assessment.