Rheumatoid Arthritis in the Hand and Wrist

• Pain (variable severity)
• Swelling and warmth of the wrist and finger joints (may come and go)
• Stiffness (usually worse first thing in the morning)
• Deformity (fingers can become “crooked” over time)

Rheumatoid arthritis is an autoimmune disorder in which your body’s immune system attacks the tissues that line the joints called synovium. This same process may also attack other tissue of the body. The exact cause of rheumatoid arthritis is unknown.

Your symptoms and medical history as well as an examination of your hand and wrist can help to diagnose arthritis. Often, X-rays of the hand and wrist will show signs of arthritis including erosions in the joints. If we suspect rheumatoid arthritis, we may need to perform additional blood tests to determine the case of the arthritis and refer you to a rheumatologist to confirm the diagnoses and initiate medical treatment.

The mainstay of treatment for rheumatoid arthritis is medications administered under the care of a rheumatologist. Modern medications have become so effective that they often prevent the need for surgery. Other nonoperative treatment options include activity modifications, splinting and steroid injections. Depending on the location and severity of the arthritis, surgical fusion or reconstruction of the joint may significantly improve symptoms in severe or long-standing cases. Sometimes tendon transfers, repairs or reconstructions help restore alignment of the wrist and fingers.