Arthritis mutilans is a severe form of arthritis that causes bone and soft tissue damage, leading to deformities in the hands and feet. It is associated with chronic rheumatoid arthritis and psoriatic arthritis and cannot be reversed. Treatment includes pain management, physical therapy, bracing, and adaptive devices. Early treatment is crucial to prevent the development of arthritis mutilans.
Arthritis mutilans is a severe form of arthritis in which bone and soft tissue damage occurs, leading to deformities, particularly in the hands and feet. It occurs in less than 10% of arthritis cases and is most commonly associated with chronic rheumatoid arthritis and psoriatic arthritis. Also known as chronic absorption arthritis, this condition can be managed in a number of ways, but the damage caused cannot be reversed.
Arthritis in general is inflammation of the joints. In patients with arthritis mutilans, chronic inflammation irritates the bone and leads to bone resorption, where bone begins to break down faster than the body can replace it. The minerals from the broken down bone enter the bloodstream and are recycled by the body. Without skeletal support, the soft tissue around the joint also begins to erode and deformities develop. These deformities are most evident in the extremities and can become highly disabling.
People with this condition may have bent fingers and toes, clubbing of the digits, and distortions in the shape of the digits. A diagnostic sign known as telescopic fingers after its distinct visual appearance can develop in patients with arthritis mutilans. The nerves remain intact and patients may continue to experience pain from the arthritis. Fingers and toes will be less flexible and agile, and it can be difficult for people to complete tasks that require fine motor skills with their hands.
Early treatment of arthritis can be beneficial for patients, as the longer it is allowed to persist without treatment, the worse the inflammation and the higher the chance of developing arthritis mutilans. For patients with this condition, medications can be used for pain management to keep the patient more comfortable, and some patients benefit from gentle physical therapy and bracing to stabilize the joints. There are instances where surgical treatments may be recommended to address the inflammation and deformity.
Adaptive devices designed to help people with poor motor skills may be beneficial for people who have arthritis mutilans. This includes devices to help people open containers, pick up items, and perform other tasks. Having tools to help can increase patient independence by reducing reliance on caregivers or family members to get things done around the home and at work. Technology such as computer voice control software, dictation software and so on can also be useful, whether people want to stay at work or communicate with friends.
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