Arthritis mutilans is a rare form of inflammatory arthritis that causes severe damage to joints and bone tissue. It most commonly develops in people with psoriatic arthritis (PsA) and rheumatoid arthritis (RA).
Arthritis mutilans primarily affects the joints in a person’s hands and feet.
This article describes the condition in more detail, including its causes, diagnosis, treatment, and outlook.
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Arthritis mutilans is a
Healthcare professionals characterize arthritis mutilans as a severe destructive joint disease with deformities that primarily affects joints in the hands and feet. The severe inflammation damages bones and soft tissues in the affected joint, which can lead to bone loss, movement issues, and changes in the shape of the joint.
Research included in a 2020 study suggests that around 5% of people with PsA develop arthritis mutilans. This rate is the same in people with RA.
Arthritis mutilans may occur independently but is most common in people with PsA or RA.
Both PsA and RA are long-term, progressive autoimmune diseases that cause inflammation throughout the body, especially in the joints. An autoimmune disease occurs when the immune system malfunctions and attacks healthy cells.
If a person does not receive effective treatment, both PsA and RA can lead to joint damage and potentially to arthritis mutilans.
Rare causes
While arthritis mutilans typically arises as a progression of RA or PsA, its symptoms can also develop in people with other conditions.
For example, older reports have described arthritis mutilans symptoms in people with:
However, cases of arthritis mutilans in people with these conditions are often isolated and, in
The main symptom of arthritis mutilans is severe bone tissue destruction. This can cause the area to become irregularly shaped and can limit movement. The condition is progressive, meaning it worsens over time, at different rates in different people.
If a person does not receive effective treatment, arthritis mutilans can
Arthritis mutilans can cause bones in the affected area to dissolve and no longer provide enough support. This can result in soft tissue collecting near the base of the finger, for example. Terms for this include “telescoping finger” and “
Arthritis mutilans can also change the shape of fingers or toes as the affected joints fuse or wear away. This can result in a loss of function in the joints. Healthcare professionals refer to this type of fusion as ankylosis.
An older 2015 review of approaches to psoriatic arthritis mutilans found that medical professionals usually look for bone and joint tissue destruction as a diagnostic marker. They also check for shortening and telescoping.
A doctor may order imaging tests, such as an X-ray, to help identify these signs of arthritis mutilans.
In addition, assessing which underlying illness has led to the condition is crucial in developing a treatment plan.
Arthritis mutilans worsens over time. Receiving early, aggressive treatment that targets the cause of arthritis mutilans may help delay or prevent further damage.
Medications doctors
- nonsteroidal anti-inflammatory drugs
- corticosteroids
- disease-modifying antirheumatic drugs
- biologic drugs
- Janus kinase (JAK) inhibitors
As with many forms of arthritis, physical therapy can be another important part of treatment if the person can undertake it.
In severe cases, a doctor may recommend surgery to repair bone and tissue damage caused by arthritis mutilans. For example, a person may benefit from bone graft procedures or surgical joint fusing. However, due to the rareness of this condition, establishing the effectiveness of these procedures will require more evidence.
Arthritis mutilans is a rare form of advanced joint disease that is most common in people with PsA and RA. It is a progressive condition that worsens if a person does not receive effective treatment.
A range of medications, physical therapies, and surgery in severe cases may slow the progression of the disease and improve a person’s quality of life.
However, if a person does not receive effective treatment, arthritis mutilans can lead to severe bone destruction and loss of movement. It can also change the shape of the affected joints.
Arthritis mutilans is a rare subtype of PsA. However, it may also affect people with RA. There are also some reports of arthritis mutilans developing in people with other health conditions.
It typically affects the hands and feet, causing severe damage to joints and bone tissue. This can lead to reduced mobility and shorten or change the shape of the fingers and toes.
Treatment will depend on the underlying cause of the condition but may include medications, physical therapy, and surgery.
A person should speak with a doctor if they think they may be experiencing symptoms of arthritis mutilans. People with PsA and RA should also discuss any new or worsening symptoms with a doctor.