Inability to extend the small finger was the presenting complaint of this 60-year-old female.
She had no other complaint.
Examination revealed she had restricted movements of her wrist but an x-ray revealed silent damage to the bones of her wrist due to rheumatoid arthritis. The diseased wrist was swollen and uneven. In the absence of pain, she presumed it to be old age-related.
She underwent surgery. The tendon responsible for extending the small finger had an attrition rupture at the level of the wrist joint. This needed surgery to prevent other tendons from getting damaged, and surgery to restore the function of the small finger. She needed surgery for the arthritic wrist as well.
Rheumatoid arthritis affects all the joints of the body leading to pain and loss of function.
The disease needs medical and surgical care.
Medicines are needed to reduce and retard the progression of the disease. Surgery is needed to prevent cartilage damage, eliminate pain and restore lost function.