Differential Features of the Hand in Rheumatoid Arthritis and Osteoarthritis
Criteria | Rheumatoid Arthritis | Osteoarthritis |
|---|---|---|
Joint swelling | Common Synovial, capsular, soft tissue | Uncommon Possibly mild swelling |
Bony hypertrophy | Only in late stages | Common, often with irregular spurs |
DIP involvement | Rare | Frequent |
MCP involvement | Frequent | Unusual, usually mild Possibly significant MCP involvement in hemochromatosis |
PIP involvement | Frequent | Frequent |
Wrist involvement | Frequent | Rare, however involvement of first CMC joint (common) sometimes perceived as wrist pain |
CMC = carpometacarpal; DIP = distal interphalangeal; MCP = metacarpophalangeal; PIP = proximal interphalangeal. | ||
Adapted from Bilka PJ: Physical examination of the arthritic patient. Bulletin on the Rheumatic Diseases 20:596–599, 1970. | ||