Rheumatoid arthritis hand deformities: Boutonniere deformity and Z deformity of the thumb

A woman with longstanding rheumatoid arthritis has soft tissue swelling and subluxation of the metacarpophalangeal joints. The right thumb shows hyperextension of the interphalangeal joint (a Z deformity). Both ring fingers have boutonniere deformities with flexion of the proximal and hyperextension of the distal interphalangeal joints.

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