[Medical Q&A] Can you still see the “swan neck” on your fingers?

Planner: Chinese Medical Association

Reviewer: Shao Zengwu, Chief Physician and Professor of Union Hospital affiliated to Tongji Medical College, Huazhong University of Science and Technology

This condition is more common in rheumatoid arthritis.

Rheumatoid arthritis has a slow onset, and in the early stages, non-specific systemic symptoms such as fatigue, generalized muscle pain, numbness and tingling in the hands and feet may occur. Subsequently, the disease recurs, and multiple small arthritis manifestations with symmetrical distribution appear. The most typical joint deformities are wrist and elbow ankylosis, metacarpophalangeal joint subluxation, ulnar deviation of the fingers, and a "swan neck"-like appearance. The most commonly affected joints are the proximal interphalangeal joints, metacarpophalangeal joints, and wrist, elbow, shoulder, knee, and toe joints. The cervical spine, temporomandibular joints, sternoclavicular and acromioclavicular joints may also be affected, with limited mobility. Hip joint involvement is rare.

The treatment goal of rheumatoid arthritis is to relieve pain, prevent joint damage, protect joint function, and maximize the patient's quality of life. Treatment mainly includes: ① Non-drug treatment. General treatment, symptomatic treatment, such as bed rest in the acute phase, appropriate activities, and proper exercise to prevent joint stiffness or deformity. ② Drug treatment. The first-line drugs are mainly non-steroidal drugs (such as indomethacin); the second-class drugs include antimalarial drugs, gold salt preparations, sulfasalazine, immunosuppressants, etc.; the third-class drugs are mainly hormones. ③ Surgical treatment. Synovectomy can be performed in the early stage, deformity correction in the middle stage, and artificial joint replacement in the late stage.