Tissue atrophy and subcutaneous edema of the rheumatoid hand. A roentgenographic study of soft tissues.

Soft tissue radiography of the hands using a mammographic immersion technique was performed on 119 patients having definite or classical rheumatoid arthritis and on 123 controls of matching age, sex and professional distribution. The grade of soft tissue atrophy in the hands was visually estimated from the radiographs and the combined cortical thickness of the second metacarpal shaft and skin thickness of the lateral side of the hand were measured. The stage of chronic edema in the absence of synovitis was estimated. Local bone cortical thickness and skin thickness have a highly significant correlation to the estimated atrophy grade. Soft tissue atrophy of hands is a sign which appears in chronic rheumatoid arthritis, especially in elderly females and has a clear correlation to the number of other irreversible radiographic signs in the hands. The incidence of moderate or advanced atrophy was 21% in rheumatoid patients. Chronic edema was found in 16%, mostly in connection with atrophic changes. A lymphatic origin of this sign is suggested.