Ulnar deviation

Medical condition involving hand deformity

Ulnar deviation, also known as ulnar drift, is a hand deformity in which the fingers are displaced towards the ulna, the bone on the side of the forearm opposite the thumb. This condition is often associated with rheumatoid arthritis, but can also occur due to other conditions affecting the joints and connective tissues of the hand.

Pathophysiology

Ulnar deviation occurs when the metacarpophalangeal joints (MCP joints) of the hand become swollen and inflamed. This inflammation can lead to the weakening of the ligaments and tendons that stabilize the joints, causing the fingers to drift towards the ulnar side. Over time, this can result in a significant deformity that affects hand function.

Causes

The primary cause of ulnar deviation is rheumatoid arthritis, an autoimmune disorder that causes chronic inflammation of the joints. Other potential causes include:

• Psoriatic arthritis
• Systemic lupus erythematosus
• Scleroderma
• Trauma to the hand
• Congenital conditions

Symptoms

The main symptom of ulnar deviation is the visible drift of the fingers towards the ulna. Other symptoms may include:

• Pain and tenderness in the affected joints
• Swelling and warmth around the joints
• Reduced range of motion
• Difficulty in performing fine motor tasks

Diagnosis

Diagnosis of ulnar deviation is typically made through a combination of physical examination and imaging studies. X-rays can reveal joint damage and the extent of the deviation. Ultrasound and MRI may also be used to assess the condition of the soft tissues and the degree of inflammation.

Treatment

Treatment for ulnar deviation focuses on managing the underlying condition and alleviating symptoms. Options include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce pain and inflammation
• Disease-modifying antirheumatic drugs (DMARDs) for rheumatoid arthritis
• Physical therapy to maintain joint function and mobility
• Splinting to support the joints and prevent further deviation
• Surgical intervention in severe cases to correct the deformity

Prognosis

The prognosis for individuals with ulnar deviation depends on the underlying cause and the effectiveness of treatment. Early intervention and appropriate management of the underlying condition can help slow the progression of the deformity and maintain hand function.

Prevention

While ulnar deviation cannot always be prevented, early diagnosis and treatment of conditions like rheumatoid arthritis can help reduce the risk of developing this deformity. Regular monitoring and appropriate management of joint health are crucial.

Related pages

• Rheumatoid arthritis
• Hand deformities
• Joint disorders

A splint used to manage ulnar deviation