{"id":4384,"date":"2022-05-03T11:47:20","date_gmt":"2022-05-03T10:47:20","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/rheumatoidarthritis-surgery\/"},"modified":"2026-04-14T14:15:41","modified_gmt":"2026-04-14T13:15:41","slug":"rheumatoidarthritis-surgery","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/plasticsurgery\/handsurgery\/rheumatoidarthritis-surgery\/","title":{"rendered":"Rheumatoid Arthritis &#8211; Surgery"},"content":{"rendered":"\n<p class=\"has-alert-red-color has-text-color\"><strong><strong><strong>This page is currently under review<\/strong><\/strong><\/strong><\/p>\n\n\n\n<title>Rheumatoid Arthritis &#8211; Surgery<\/title>\n\n\n\n<div class=\"wp-block-getwid-tabs\" data-active-tab=\"0\"><ul class=\"wp-block-getwid-tabs__nav-links\"><\/ul>\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Referral Guidelines<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<h3 class=\"wp-block-heading\">What we will see<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Diagnostic difficulties<\/li>\n\n\n\n<li>Patients with a diagnosis of Rheumatoid arthritis who are having functional issues with their hands<\/li>\n\n\n\n<li>Pain unresponsive to simple non-interventional measures<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\">What we won&#8217;t see<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Straightforward diagnosis with no functional deficit<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\">Specific tests<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Clinical examination of joint \u2013 palpation, range of movement<\/li>\n\n\n\n<li>X-ray of affected part (be specific about digit and joint on request)<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\">Trial of therapy pre-referral<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>If no functional deficit then no treatment required<\/li>\n\n\n\n<li>Trial of oral analgesia or topical NSAID gel<\/li>\n\n\n\n<li>Activity modification<\/li>\n\n\n\n<li>Consider appropriate splintage<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\">Whom to direct referral to<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Any hand surgeon<\/li>\n<\/ul>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Resources and Links<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<ul class=\"wp-block-list\">\n<li><a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/BSSH-CARPAL-TUNNEL-1.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Plastic Surg \u2013 PIL BSSH CARPAL TUNNEL Aug18<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/BSSH-GANGLIA.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Plastic Surg \u2013 PIL BSSH GANGLIA Aug18<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/BSSH-OA-THUMB.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Plastic Surg \u2013 PIL BSSH OA THUMB Aug18<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/BSSH-TRIGGER-FINGER.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Plastic Surg \u2013 PIL BSSH TRIGGER FINGERAug18<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/www.nice.org.uk\/\" target=\"_blank\" rel=\"noreferrer noopener\">National Institute for Health and Care Excellence (NICE)<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/www.guidelinesinpractice.co.uk\/home\/the-scottish-intercollegiate-guidelines-network-sign\/305547.article\" target=\"_blank\" rel=\"noreferrer noopener\">Scottish Intercollegiate Guidelines Network (SIGN)<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Wrist-Pain-Algorithm-of-Differential-Diagnoses.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Wrist Pain Algorithm of Differential Diagnoses<\/a><\/li>\n<\/ul>\n<\/div><\/div>\n<\/div>\n\n\n\n<p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>This page is currently under review Rheumatoid Arthritis &ndash; Surgery<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":3988,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"categories":[562],"class_list":["post-4384","page","type-page","status-publish","hentry","category-rheumatoidarthritissurgery"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"NHS Lothian","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/nhs-lothian\/"},"rttpg_comment":0,"rttpg_category":" <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/plasticsurgery\/handsurgery\/rheumatoidarthritissurgery\/\" rel=\"tag\">Rheumatoid Arthritis - Surgery<\/a>","rttpg_excerpt":"This page is currently under review Rheumatoid Arthritis &ndash; Surgery","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4384","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=4384"}],"version-history":[{"count":6,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4384\/revisions"}],"predecessor-version":[{"id":27636,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4384\/revisions\/27636"}],"up":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3988"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=4384"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=4384"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}