Medical aspects of rheumatoid arthritis. Diagnosis and treatment.

Rheumatoid arthritis commonly affects the hand and wrist. The differential diagnosis of inflammatory conditions affecting the hand is broad. A proper diagnostic approach necessitates a thoughtful interpretation of the presenting clinical features, laboratory tests, synovial fluid analysis, and radiographic data. Early, aggressive medical therapy with a combination of antiinflammatory and remittive agents may reduce mortality in selected patients and prevent the consequences of uncontrolled synovial proliferation. Despite proper medical therapy, joint destruction often results and surgical treatment of the joint deformities may be required for restoration of function.