BMJ Case Reports 2013; doi:10.1136/bcr-2013-009884

Severe rheumatoid arthritis hand deformity

  1. M Chadi Alraies1
  1. 1Department of Hospital Medicine, Cleveland Clinic, Cleveland, Ohio, USA
  2. 2American University of Beirut Medical Center, Beirut, Beirut, Lebanon
  3. 3Department of Pulmonary Diseases, Critical Care, & Environmental Medicine, Tulane University Health Sciences Center, New Orleans, Louisiana, USA
  1. Correspondence to Dr M Chadi Alraies, alraies{at}


A 49-year-old woman with a medical history of hypertension and rheumatoid arthritis presented with severe bilateral hand pain due to arthritis. She was diagnosed with rheumatoid arthritis at the age of 20 years and has been on anti-inflammatory medications and steroids since then. She was treated with methotrexate for a short period of time, but this was stopped due to gastrointestinal intolerance. She has been on prednisone and ibuprofen only for the last 15 years and has been a nursing home resident for the last 5 years due to severe hand deformities and inability to use …

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