Systemic lupus erythematosus (SLE) is a multisystemic, autoimmune, rheumatic disease involving the joints and skin in up to 90% of affected individuals. SLE affects various organ systems simultaneously, and its course is typically recurrent, with periods of relative remission followed by relapses. Hand involvement is a common manifestation and can vary considerably from mild arthralgia to severely deformed hands. Treatment varies widely depending on the systemic involvement and disease severity, but conservative management generally focuses on a course of disease-modifying antirheumatic drugs (DMARDs) and other pharmacologic interventions, while surgical procedures like tendon rebalancing, arthrodesis and arthroplasty are typically reserved for patients with advanced deformity and severe functional impairments.1,2
Special Laboratory Work-up Diagnosis
Reproduced from the International statistical classification of diseases and related health problems, 10th revision, Fifth edition, 2016. Geneva, World Health Organization, 2016 https://apps.who.int/iris/handle/10665/246208
The typical patient is a 42-year-old African-American woman who presents with a range of symptoms affecting several systems, including a malar rash, chest pain, shortness of breath, and fatigue, as well as arthralgia, stiffness, swelling, and loss of strength in her hands and wrists. The rheumatoid arthritis-like symptoms have advanced, which now interferes with her ability to perform many basic daily activities requiring the use of her hands.
Nonpharmacologic and Preventative