Arthritis mutilans is a rare form of inflammatory arthritis that causes severe inflammation. This leads to the wearing down of joints and bone tissues in the hands and feet.
This article will look at the causes of arthritis mutilans (AM), its symptoms, how it is diagnosed, and what treatment options are available.
Arthritis is an autoimmune disease that causes inflammation, particularly in the joints.
Rheumatoid arthritis (RA) and psoriatic arthritis (PsA) are two conditions that can progress to AM.
RA is a long-term, progressive autoimmune disease that causes inflammation throughout the body, especially in the joints.
Also an autoimmune disease, PsA causes joint pain, swelling, and inflammation to the skin. If not controlled, both conditions can lead to joint damage.
As a severe form of RA or PsA, AM destroys bone and cartilage of joints and causes bone resorption. Bone resorption is part of the bone modeling process involving the breakdown and absorption of old bone tissue.
In people with AM, bone tissue rebuilding does not take place. Instead, the soft tissues of the bones collapse.
Arthritis mutilans in PsA and RA
Arthritis mutilans is one of the most severe forms of PsA. It is marked by clear and severe damage to the bone tissue in the joints.
One study found that people with PsA who eventually develop severe joint damage and deformity have higher disease activity when symptoms begin.
In 2003, The New England Journal of Medicine reported on a 94 year old woman who had RA since childhood. When she first sought treatment in her 60s, she presented with AM and severe joint deformity. Imaging showed severe bone resorption in her hands and wrists and collapse of the bone tissue.
This created a condition called “telescoping fingers.” Telescoping fingers occurs when the bones dissolve and soft tissues cannot hold the fingers up and they end up pulling together in a heap-like fashion.
In RA, severe AM deformities are most visible in the hands and wrists. They tend to occur when RA is not properly treated.