Prevalence of hand deformities and factors that influence it in patients with rheumatoid arthritis

ABSTRACT

Hand deformity is a typical feature of the RA. Therefore it is crucial to find out the prevalence of hand deformity in RA and to identify factors associated with its presence. A group of 100 patients with RA fulfilling the 1987 revised ACR criteria, were attending routine out patient clinics and physiotherapy unit in Rizgary Teaching hospital in Erbil, between 1[st] Oct. 2008 to 31[st] June 2009, are included, Patients who had congenital anomaly, history of trauma, patients below 16 years and other rheumatologic disease had been excluded. Hand deformity was recorded in [57%] of cases The frequency of deformities was as follow; ulnar deviation of the MCP joints [41%], palmer subluxation of the MCP joint [38%] Z deformity[13%], jDoutonniere deformity [27%], swan neck deformity[35%], radial deviation of the wrist [24%] and subluxation of the wrist joint [16%]. Female to male ratio was 51, 55% Of patients were between 40-59 years of age. X-ray of both hand shows 60% of patients had bone erosion, RF was positive in 73% of patients, CRP was positive in 75%. Family history was positive in 30%. There was a significant correlation between development of deformities and disease duration, No. of joints involved, RF[Rheumatoid Factor], CRP[C-reactive protein] and ESR[Erythrocyte sedimentation rate], other factors that had been studied but had no significant correlation with development of deformities which were age, gender, occupation, residence, type of treatment, Rheumatoid arthritis is a chronic rheumatologic disease that affects the hand and causes deformities, which mainly depend on the duration of disease, so early treatment and suppression of inflammation is necessary to delay or arrest the development of deformities