Management of the rheumatoid hand

The hand is often forgotten in the management of rheumatoid arthritis. Rheumatoid disease in the hand, as elsewhere, can be divided into three phases: the early proliferative stage, the period of synovial regression and the stage of fixed deformity. Our studies suggest that the eventual pattern of hand deformity is related to the site, severity and sequence of synovial involvement. It is, therefore, likely that the results of early medical and surgical treatment of the rheumatoid hand will be more rewarding than those of late reconstructive procedures.