Rheumatoid patients are unique. Their form of arthritis (inflammatory arthritis) is very debilitating and they often have high pain thresholds as they have had to deal with significant joint inflammation and degeneration for long periods of time. The inflammatory arthritis affects not only their joints, but their tissues, immune and other organ systems. This requires attentive medical and surgical care of their condition.
Thankfully the number of patients that are referred to orthopaedic surgeons for rheumatoid related conditions is decreasing due to the advances in medical management and specifically the ‘biologicals’ the GP or rheumatologist prescribes.
Rheumatoid arthritis very commonly affects the upper limb, involving the hands, wrists, elbows and shoulders. It may progress to affecting their ability to perform simple daily tasks such as opening a jar, or keep them awake at night due to pain. In the hands and wrists, it typically creates progressive deformities at each joint level. It is crucial to understand how deformity at one level influences the next, as digital balance in the hand is the most complex musculoskeletal equilibrium in the body.