Current concepts and treatment for the rheumatoid wrist

  • Rizzo M
  • Cooney 3rd W
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Abstract

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.

Author-supplied keywords

  • Arthritis, Rheumatoid/diagnosis/*surgery/therapy
  • Humans
  • Synovitis/surgery
  • Wrist Joint/*surgery
  • Wrist/surgery

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Authors

  • M Rizzo

  • W P Cooney 3rd

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