Current concepts and treatment for the rheumatoid wrist

  • Rizzo M
  • Cooney W
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Wrist involvement in rheumatoid arthritis (RA) is common. Within 2 years of diagnosis, more than half of patients will have wrist pain, and more than 90% will have wrist disease by 10 years. Although wrist involvement is generally thought to be less disabling than RA of the fingers and hand, it can be a significant cause of pain and disability. Severe disease with bony destruction and synovitis in the wrist can also result in soft-tissue problems including tendon ruptures. In addition to musculoskeletal involvement, systemic manifestations of RA can occur. Felty syndrome can result in a low white blood count and splenomegaly in association with RA. New generation, disease-modifying pharmacologic agents offer promise in controlling the disease progression. Surgical treatments for the diseased wrist are aimed at relieving pain and restoring function. Common procedures include: synovectomy and tenosynovectomy, tendon reconstruction, distal ulnar resection and/or distal radioulnar joint reconstruction, partial and full wrist arthrodesis, and total wrist arthroplasty. (copyright) 2011 Elsevier Inc.

Author-supplied keywords

  • adalimumab
  • arthralgia
  • arthrodesis
  • bone destruction
  • cartilage degeneration
  • clinical trial
  • corticosteroid
  • distal ulna resection
  • etanercept
  • hand function
  • human
  • infliximab
  • joint destruction
  • joint instability
  • lower respiratory tract infection
  • methotrexate
  • methylprednisolone
  • radioulnar joint
  • range of motion
  • review
  • rheumatoid arthritis
  • soft tissue infection
  • splinting
  • steroid
  • surgical approach
  • surgical technique
  • synovectomy
  • synovitis
  • tendon reconstruction
  • tendon rupture
  • tenosynovectomy
  • tumor necrosis factor inhibitor
  • ulnar head arthroplasty
  • wrist
  • wrist arthrodesis
  • wrist arthroplasty
  • wrist radiography

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  • M Rizzo

  • W P Cooney

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