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Arthritis mutilans is a severe form of arthritis where damage to the bone and soft tissue occurs, leading to deformity, 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 absorptive arthritis, this condition can be managed in a number of ways, but the damage caused cannot be reversed.
Arthritis in general is an inflammation of the joints. In patients with arthritis mutilans, the chronic inflammation irritates the bone and leads to bone resorption, where bone starts breaking down faster than the body can replace it. The minerals from the broken down bone enter the bloodstream and are recycled by the body. Lacking skeletal support, soft tissue around the joint starts to erode as well, and deformities develop. These deformities are most striking 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 telescoping fingers after its distinct visual appearance can develop in patients with arthritis mutilans. The nerves remain intact and patients can continue to experience pain as a result of the arthritis. The fingers and toes will be less flexible and agile and it can be difficult for people to complete tasks requiring fine motor skills with their hands.
Treating arthritis early can be helpful for patients, as the longer it is allowed to persist without treatment, the worse the inflammation, and the greater the chances 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 braces to stabilize the joints. There are cases where surgical treatments may be recommended to address the inflammation and deformity.
Adaptive devices designed to help people with poor motor skills can be helpful for people who have arthritis mutilans. This includes devices to help people open containers, pick things up, and perform other tasks. Having tools to help can increase independence for the patient by reducing reliance on assistants or family members for doing things around the house and on the job. Technology like voice control software for computers, dictation software, and so forth can also be helpful to have, whether people want to stay at work or communicate with friends.
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