ABSTRACT
The prevalence of rheumatoid arthritis has been reported to be between 1 and 2% of the adult population.1-18 The incidence tends to increase with age and is reported at as high as 10% in adults over 65.1 Rheumatoid arthritis is a systemic, autoimmune-mediated inflammatory disorder that alters the synovium around joints and tendons.1-9 As the synovium proliferates in the joint and tendon sheath, inflammatory cells invade the subsynovial layer, and synovitis results. This process invades the subchondral bone at the margins of the articular surface or along vascular channels. As the disease progresses, the articular cartilage and the surrounding ligament are destroyed by pannus, and soft-tissue structures become incompetent. Disruption of the normal skeletal anatomy of the wrist and hand alters the delicate balance of muscles and tendons.2 Involvement of the tendons and joints may begin as mild synovitis with symptoms due to increased pressure, nerve entrapment or impairment of tendon glide, as is observed with trigger-finger disorders. The wrist and hand are the most commonly affected areas in rheumatoid arthritis.
