The Rheumatoid Wrist


Rheumatoid arthritis (RA) is a systemic, autoimmune-mediated disease that affects 1% to 2% of the population. The disease is characterized by an inflammatory synovitis that can erode and ultimately destroy joint surfaces. People of all ages may be affected by RA, but the disease usually begins in middle age, and women are affected more often than men. The etiology of RA is unknown, although researchers believe that some people have genes that make them susceptible to the disease. Of the upper extremity joints, the wrist is the most commonly affected by RA. Disease-modifying antirheumatic drugs, such as methotrexate, and gold therapy are used in the early stages of the disease. Selective surgical intervention by synovectomy can be used bring the inflammation under control and prevent joint damage until medical treatment is efficacious. End-stage arthritis requires total wrist arthroplasty or complete or partial fusion of the wrist joints.

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