Development rate of mutilans fingers in patients with rheumatic disease

Objective To describe arthritis mutilans (AM) deformity during the progression of rhe umatic disease. Methods The development of mutilans-like hand deformities in 2 patients with juveni le chronic arthritis (JCA) and in 2 patients with adult onset rheumatoid ar thritis (RA) are presented. The hands of these patients were evaluated at l east at two time points during the course of disease using two different sc oring methods based on differently summed Larsen grades of the hand joints. Results Two patients (one with JCA and one with RA) showed AM changes after a disea se period of less than 10 years and 2 not until after 30 years. The patient s with adult onset disease were young at the onset of joint disease. Early wrist fusions were performed on both patients showing a slow development ra te. Conclusions The development rate of AM is very variable, even in patients with the same diagnoses. Wrist fusion prevents shortening of the carpus and may decrease the development rate of AM.