Wrist and Finger Deformities in Juvenile Rheumatoid Arthritis

Summary

A study of the notes and x-rays of 414 patients suffering from juvenile rheumatoid arthritis shows that:

1. The wrist joint is the most commonly affected joint in the hand.

2. The disease process is shown statistically to be less damaging in males than in females.

3. Wrist disease leads to shortening of the ulna, and a high incidence of radial and ulnar deviation of the hand. The ulnar bayonet deformity is described.

4. In the younger patients

   • the most common finger deformity is flexion at the DIP and PIP joints,

   • radial deviation of the hand is associated with flexion deformity of the fingers,

   • ulnar deviation of the hand is associated with radial deviation of the index and middle fingers.

   • Periostitis is usually followed by severe local joint changes.