What does finger phalanx deformation mean?

The most common cause of finger joint deformity is rheumatoid. You can go to the hospital to check rheumatoid factor and erythrocyte sedimentation rate. At first, the joints are often slightly sore and stiff, and the disease alternately relieves the recurrence and gradually worsens, often accompanied by systemic symptoms such as fatigue, anorexia, fever, anemia and weight loss. The following can refer to (1) the clinical manifestations of arthritis: ① morning stiffness and joint stiffness: all patients with rheumatoid arthritis have this manifestation, which is one of the important diagnostic basis. It is characterized by stiff joints and inflexible activities in the morning or after waking up. In severe cases, it can cause the whole body stiffness, which will be relieved or disappeared after getting up and exercising or keeping warm. The phenomenon of morning stiffness shows that rheumatoid arthritis is active, and the duration of morning stiffness is consistent with the severity of the disease. Morning stiffness is often accompanied by chills and numbness in limbs or toes. Morning stiffness can be divided into three degrees: a. Mild morning stiffness: morning stiffness is relieved or disappeared within 1 hour after getting up; B. Moderate morning stiffness: morning stiffness will be relieved or disappeared within 1 ~ 6 hours after getting up; C. Severe morning stiffness: morning stiffness is relieved or disappeared more than 6 hours after getting up, or it is all morning stiffness. ② Joint swelling or pain: This is also a necessary symptom for almost all patients with rheumatoid arthritis. Most patients begin with joint swelling. The swelling is due to the increase of exudate in the joint cavity and the inflammatory changes of soft tissue around the joint, which is characterized by uniform swelling around the joint. Spindle swelling of the proximal phalanx is one of the typical symptoms of rheumatoid patients. The severity of joint pain is usually parallel to the degree of swelling. The more obvious the joint swelling, the heavier the pain, even severe pain. Because of the intense pain, when someone reaches out to touch his joint, the patient blocks it with his hand to protect or retract the joint. If it is allowed to move its joints actively, it can sometimes stretch and bend reluctantly. Clinically, we should pay attention to whether there is spontaneous pain and active pain. Spontaneous pain refers to the pain when the joints are inactive or in a quiet natural position, and sometimes even wake up from sleep, suggesting that the lesion develops rapidly or urgently and is more serious; Activity pain means that the pain is felt only when the joints are active, indicating that the joint inflammation is mild or tends to be relieved. Rheumatoid joint pain is characterized by relief after exercise and aggravation at the beginning of exercise after rest. For example, it is difficult to stand, start and walk after sitting for a long time, and patients often "can't sit down, get up and sit down; After the fingers and elbows have been flexed for too long, the pain is aggravated when they are just straightened. " However, these phenomena are relieved after short-term activities, and they gradually move freely, and the pace of walking can be accelerated. In the morning, when the joint is stiff and the swelling and pain are serious, the patient loses part or all of his self-care ability. Joint pain is aggravated when it rains, catches cold and catches cold in the morning, evening and cloudy days, especially when you have a cold. During the examination, the joints were swollen and most of them were not red, showing the true color of the skin; There are also reddish or purplish ones, which are more common in children's foot FD A3 or finger joint swelling. Joint fever, tenderness or obvious tenderness. There are obvious fluctuations in joint effusion, especially in knee joint. Joint swelling is most easily detected at the small joints of limbs, while swelling of shoulders and hips is difficult to detect. ③ Joints involved: Rheumatoid can affect any of 65,438+0,87 synovial joints in human body, including synovium, cartilage, bone, tendon, ligament, synovial sac and sarcolemma. The common joints involved are toe, FD A3, ankle, wrist, elbow, knee, hip, temporomandibular joint, chest rib, neck and shoulder. According to statistics, about 30% patients have the first onset. 26% patients had the first onset of knee joint; 10% of the patients first developed wrist joint. There were 1 ~ 3 joints at the onset of rheumatoid arthritis, and the number of joints involved in most patients was above 4 ~ 10. According to records, rheumatoid disease rarely invades distal finger and toe joints. ④ Arthritis metastasis: Arthritis develops from one joint to another, which has the following three characteristics: a. Wandering: Early joint pain (no swelling) has obvious wandering, and the wandering interval is relatively short, mostly in 1 ~ 3 days, and rarely exceeds 1 week. Once a joint is swollen, the swelling lasts for a long time on this joint. The swelling of the first joint usually lasts for more than 3 months to 1 year after onset, which is an important feature different from other arthritis. After the onset of the first joint swelling, it usually takes 1 ~ 3 months to transfer to another joint or another pair of joints, that is, the wandering interval of joint swelling is more than 1 month, which is another important feature different from other arthritis. Since then, joint swelling and pain is like a "relay race". This swelling and pain has not disappeared, and another joint or joints have begun to have swelling and pain; B. symmetry: the migration (metastasis) of arthritis is often symmetrical, and joint pain is rarely asymmetrical except for early migration pain. Monoarthritis is rare; C. Mutual containment phenomenon: After the swelling of the first joint is transferred to another joint, the swelling and pain of the (first) joint will be relieved rapidly (1 ~ 3 days), and will disappear completely after several weeks to several months, while the swelling and pain of the newly developed joint will become more and more serious. ⑤ Rubbing sound of joints: In rheumatoid arthritis, when the examiner's hands move joints, especially elbows and knees, he can often feel tiny twisting sound or the feeling of scratching snow, suggesting that the joints are inflamed. After the inflammation of some joints subsides, the clicking sound can be heard or felt in movable joints, especially in fingers, knees and buttocks, which may be caused by rheumatoid arthritis with hyperosteogeny. ⑥ Limited joint function and activity: In the early stage of joint swelling, most patients dare not move because of severe pain, and joint function is limited. Generally speaking, the degree of limited joint activity is consistent with the degree of inflammation. The limitation of joint movement in the later stage is mainly caused by joint stiffness and various deformities. The degree of joint stiffness and deformity is related to the timely and correct medical guidance, the importance of functional exercise, the speed of disease progress and other factors. When the joint function is seriously damaged, the patient partially or completely loses the ability of self-care or is bedridden, and it is difficult to turn over, get up, dress, unbutton, comb his hair, brush his teeth, take chopsticks, eat, wash clothes, bend over and walk. Common deformities are "rheumatoid hand" and "rheumatoid foot". The deformity characteristics of rheumatoid hand are as follows: a. Goose neck deformity: metacarpophalangeal joint flexion, proximal phalangeal joint hyperextension, distal phalangeal joint flexion, and finger shape looks like a goose's neck from the side; B buttonhole deformity: the proximal knuckles are flexed, the distal knuckles are overstretched, and the hands are buttonhole-shaped; C. Fin-shaped hand: At first, only the metacarpophalangeal joint and the proximal phalangeal joint were spindle-shaped swollen, and then gradually shifted to the ulnar side, showing a flipper shape, and in severe cases, it could develop to the wrist joint. The deformities of rheumatoid foot are subluxation of metatarsophalangeal joint and valgus of FDA5 toe joint, as well as deviation to fibula side and deviation of metatarsophalangeal joint to plantar side, which can cause severe pain and difficulty in walking. (2) Periarticular lesions ① Rheumatoid subcutaneous nodules: It is more common when rheumatoid disease is highly active, erythrocyte sedimentation rate continues to increase, and rheumatoid factor is positive, which is one of the criteria for determining rheumatoid disease and judging pathological activity. The incidence of rheumatoid subcutaneous nodules is 5% ~ 25%, and the size is about 0.2c m~3cm ~ 3 cm, like lentils, peanuts, walnuts, etc., which are round or oval, usually as hard as bones, painless and movable. Its number varies from one to dozens, and it is more common around joints, especially at the extension of elbow olecranon, wrist and knuckles. In addition, connective tissue is all over the body. ② Muscle atrophy and muscle weakness near joints: Muscle atrophy and muscle weakness near joints appear quickly, some of them can appear in 10 ~ 12 days, and most of them are obvious after several weeks, especially extensor atrophy. Muscle atrophy is usually accompanied by pain, burning sensation, stiffness, weakness, allergy or hypoesthesia, muscle tension or tenderness. Muscle weakness is often manifested as decreased grip strength, inability to walk for a long time in both lower limbs, weakness in both knees or sudden kneeling. Therefore, the grip strength of both hands and walking time are used as indicators of therapeutic effect in clinic. On the basis of muscle atrophy, muscle sclerosis and contracture will occur. Due to muscle atrophy, contracture and joint dislocation, the joints of fingers, toes or limbs are deviated to the outside. ③ Bone involvement: Patients with rheumatoid arthritis may have aseptic (ischemic) necrosis of the femoral head and other parts of the bone, which may lead to disability in severe cases. Severe rheumatoid osteoporosis often causes bone pain, limited joint activity and spontaneous fractures.