Severe disabling hand and foot deformity in an untreated patient of Rheumatoid Arthritis (RA)

Rheumatoid arthritis (RA) is a multisystem immune-mediated inflammatory disease, with female predominance, affecting the synovial joints. Bilateral symmetrical inflammation, joint destruction, deformity, and disability, are the typical presentation of the disease. Inflammatory arthritis involving the small joints of the hands is a common presentation, however, other joints are also involved in the later course of the disease. The biological disease-modifying anti-rheumatic drugs (DMARDs) are the most effective drug to achieve and maintain complete remission, whereas NSAIDs are used for symptomatic pain relief. The severe deformity is needed to be corrected by surgical management to restore joint function. We present a clinical image of severe disability of hand and foot in an untreated patient of RA, coming from the rural area of Gujarat, suggestive of lack of awareness as well as non-compliance to the treatment in these regions. The awareness programs need to target these populations for early diagnosis and proper treatment of RA.