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The hand in systemic lupus erythematosus.

C J Bleifeld, A E Inglis

    The Journal of Bone and Joint Surgery. American Volume
    |September 1, 1974
    PubMed
    Summary

    Systemic lupus erythematosus (SLE) hand involvement differs from rheumatoid arthritis, often presenting with Raynaud's phenomenon as the primary cause of disability. Characteristic deformities include swan neck and thumb hyperextension due to soft-tissue laxity, not joint destruction.

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    Area of Science:

    • Rheumatology
    • Immunology
    • Hand Surgery

    Background:

    • Hand involvement is a frequent manifestation of systemic lupus erythematosus (SLE).
    • SLE hand presentation is distinct from rheumatoid arthritis (RA).
    • Raynaud's phenomenon is a significant contributor to disability in SLE patients.

    Purpose of the Study:

    • To delineate the characteristic features of hand involvement in systemic lupus erythematosus.
    • To differentiate SLE hand manifestations from those observed in rheumatoid arthritis.
    • To identify the primary causes of disability in SLE patients with hand involvement.

    Main Methods:

    • Clinical observation and assessment of patients with systemic lupus erythematosus.
    • Comparison of hand deformities and symptoms between SLE and rheumatoid arthritis patients.
    • Evaluation of the role of Raynaud's phenomenon in SLE-related hand disability.

    Main Results:

    • Raynaud's phenomenon was present in 50% of SLE patients, often being the main cause of disability.
    • SLE hand deformities result from laxity of soft-tissue supporting structures.
    • Characteristic deformities include swan neck deformities and thumb interphalangeal joint hyperextension.
    • Articular destruction and ankylosis are absent in SLE hands unless rheumatoid arthritis is coexistent.

    Conclusions:

    • Hand involvement in SLE has unique features, primarily driven by soft-tissue laxity and Raynaud's phenomenon.
    • Distinguishing SLE hand involvement from rheumatoid arthritis is crucial for appropriate management.
    • Early recognition of characteristic deformities can guide therapeutic strategies for SLE patients.

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