title: Current concepts and treatment for the rheumatoid wrist.
abstract: Wrist involvement in rheumatoid arthritis (RA) is common. Within 2 years of diagnosis, more than half of patients will have wrist pain, and more than 90% will have wrist disease by 10 years. Although wrist involvement is generally thought to be less disabling than RA of the fingers and hand, it can be a significant cause of pain and disability. Severe disease with bony destruction and synovitis in the wrist can also result in soft-tissue problems including tendon ruptures. In addition to musculoskeletal involvement, systemic manifestations of RA can occur. Felty syndrome can result in a low white blood count and splenomegaly in association with RA. New generation, disease-modifying pharmacologic agents offer promise in controlling the disease progression. Surgical treatments for the diseased wrist are aimed at relieving pain and restoring function. Common procedures include: synovectomy and tenosynovectomy, tendon reconstruction, distal ulnar resection and/or distal radioulnar joint reconstruction, partial and full wrist arthrodesis, and total wrist arthroplasty.
authors.affiliation: Department of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. rizzo.marco@mayo.edu
authors.forename: Marco
authors.initials: M
authors.lastname: Rizzo
authors.forename: William P
authors.initials: WP
authors.lastname: Cooney
mesh_terms: D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000601:surgery* / Q000628:therapy; D006801:Humans; D013585:Synovitis / Q000601:surgery; D014953:Wrist / Q000601:surgery; D014955:Wrist Joint / Q000601:surgery*