Ankylosis of the finger joints in rheumatoid arthritis.

The ordinary manifestations of rheumatoid arthritis are well known and readily recognized. They are subject to wide variations and, as they deviate farther from the conventional picture, diagnosis becomes difficult, doubtful, or even impossible. The aetiology is unknown and proof of diagnosis is lacking. Even the proposed diagnostic criteria for rheumatoid arthritis (Ropes, Bennett, Cobb, Jacox, and Jessar, 1957) have not completely eliminated the difficulty, although they have made greater uniformity of classification possible. Under such circumstances, doubtful cases conforming to some diagnostic criteria but not to others are of considerable interest and often worthy of detailed study. Bony ankylosis of joints is a characteristic result of rheumatoid arthritis in a small proportion of cases, but it is non-specific for the disease. Several cases in which ankylosis of the finger joints has occurred or has been an outstanding feature have been observed which seem worthy of further attention and will be described here. In two such cases, ankylosis of the interphalangeal joints of the fingers were observed in long-standing, generalized, and severely crippling rheumatoid arthritis. These cases are described briefly for comparison. Two other cases, however, have been followed for several years, one through a period of soft tissue inflammation and bone destruction, progressing into ankylosis. The trouble with the fingers has been the outstanding complaint. No other joints have been involved, general health has not been impaired, and since the inflammation has subsided, immobility of the fingers has been the only complaint.