Orthopaedic Nurses Certification Board (ONCB) Metabolic/Inflammatory/Tumors Practice Exam

Which of the following is a sign of early rheumatoid arthritis in hands?

1. Boutonniere deformity

2. Swan-neck deformity

3. Ulnar deviation

4. Spindle-shaped fingers

The correct answer is: Spindle-shaped fingers

In the context of early signs of rheumatoid arthritis, spindle-shaped fingers can indeed be indicative of joint swelling associated with inflammatory changes. The condition typically leads to soft tissue swelling in the proximal interphalangeal joints, which can cause the fingers to appear broader in the middle and taper towards the ends, contributing to the spindle-like shape. This symptom can manifest early in the disease process, highlighting the inflammatory nature of rheumatoid arthritis. On the other hand, the boutonniere and swan-neck deformities are more commonly associated with chronic stages of the disease, developing over time as a result of joint damage and prolonged inflammation. Ulnar deviation, while also seen in rheumatoid arthritis, usually occurs as the disease progresses and joint integrity is compromised. Understanding the distinctions between these clinical signs is essential. Early identification of such signs can facilitate timely intervention, potentially modifying the disease course and improving patient outcomes.