What Are the Signs and Symptoms of Arthritis Mutilans

You may see some main signs if you have arthritis mutilans.

Here are the most common symptoms:

Many people also say they have swelling and strong pain. Finding these signs early helps you get better results. Each symptom will be explained more in the next parts.

Key Takeaways

• Arthritis mutilans causes very bad joint damage, mostly in hands and feet. Noticing symptoms early can help doctors treat it better.
• Digital shortening happens when fingers or toes look shorter. This is because the bones get smaller. This symptom is special to arthritis mutilans.
• Telescoping deformities make fingers and toes look like a closed telescope. This happens when bones break down and lose their shape.
• Severe pain is a usual symptom. It can make daily life hard. You should see a doctor if pain gets worse.
• Swelling in joints is different for each person. Writing down which joints are swollen helps doctors give better care.
• Joint deformities and less movement can make daily tasks hard. Special tools can help you do things more easily.
• Symptoms usually get worse over time. Keeping a journal of changes helps you and your doctor watch the condition.
• If you see changes in your fingers or toes, talk to a doctor soon. Early treatment can slow down joint damage.

Arthritis Mutilans: Main Signs

Joint Deformity

Joint deformity is easy to see in arthritis mutilans. Your fingers or toes may change shape slowly. These changes look much worse than in other arthritis types. Your hands and feet can look twisted or bent.

Bone Loss

Bone loss means the bone in your fingers or toes breaks down. This is called osteolysis. Your fingers or toes may look thinner or shorter. Doctors can see bone loss on X-rays.

The bones look like they are fading away. Pencil-in-cup deformity is a common sign. One bone looks sharp and fits into a cup shape on another bone. Bone loss can make bones join together. This is called ankylosis.

• Big erosive changes often show up in wrist and finger joints.
• Severe bone thinning makes bones look less solid.
• Joint changes like telescoping and ulnar deviation can also happen.

Collapsed Joints

Collapsed joints happen when bones lose too much tissue. The space between bones goes away. Bones can slide into each other. This makes fingers or toes look much shorter. The collapse causes a “telescoping” effect. The finger or toe can fold in, like a small telescope. Your joints may feel loose or wobbly.

Digital Shortening

Digital shortening means fingers or toes look much shorter. This happens because bone tissue breaks down and disappears. Doctors may call this “opera glass hand” or “telescoping fingers.” These changes are special to arthritis mutilans. Other arthritis types do not cause this.

• Digital shortening comes from bone loss and erosions.
• MRI scans often show high bone swelling scores. These link to severe bone loss and shorter fingers.
• Reports say some patients have fingers that pull out and push back, like a telescope.

Severe Pain

Severe pain is a main sign of arthritis mutilans. You may feel pain much worse than in other arthritis types. This pain often hits your hands and feet. It can make moving or using them hard. The pain may stay all the time or get worse when you move.

If you have strong pain with joint changes or shorter fingers, talk to your doctor soon. Early treatment can help slow down the damage.

Swelling

Swelling is a common sign you may notice if you have arthritis mutilans. Your fingers or toes can look puffy and feel tender.

The skin around your joints may stretch and appear shiny. Swelling often makes it hard for you to bend or use your hands and feet.

You might see swelling in just one joint or in several at the same time. The amount of swelling can change from day to day. Sometimes, your joints feel warm when you touch them. Swelling can make your fingers and toes look larger than normal.

Doctors use swelling to help find out how much your joints are affected. You may have only one swollen joint, or you could have many. Studies show that the number of swollen joints in people with arthritis mutilans can be different for each person:

• The median number of swollen joints per patient is 1.
• Some people have no swelling, while others may have up to 16 swollen joints.

Swelling in arthritis mutilans is usually more severe than in other types of arthritis. The swelling can last a long time and may not go away with rest.

You may feel pain and stiffness along with the swelling. If you notice swelling that does not improve, you should talk to your doctor.

Keep track of which joints swell and how often. This helps your doctor understand your symptoms and choose the best treatment.

Telescoping Fingers and Toes

What It Looks Like

You may notice your fingers or toes start to look very different if you have arthritis mutilans. The most striking change is called “telescoping.”

This happens when the bones in your fingers or toes break down and collapse. The skin over your joints may look loose or wrinkled. Your fingers can appear much shorter than normal, almost as if they have shrunk.

When you move your fingers, you might see them slide in and out, just like the sections of a telescope. This movement happens because the bones inside have lost their normal shape and support.

The joints no longer hold the bones in place. Sometimes, you can even stretch or compress your finger, and it will move back and forth under the skin. Doctors often call this look “opera glass hand” because your fingers can open and close like old-fashioned opera glasses.

You may also see that your fingers or toes bend in odd directions. The joints may look swollen, and the skin can seem shiny or stretched. These changes make your hands and feet look very different from normal.

The unique appearance of telescoping fingers and toes comes from the loss of bone, called osteolysis, and the collapse of the joints. This effect is not seen in most other types of arthritis.

If you notice your fingers or toes changing shape, especially if they seem to shorten or move in unusual ways, you should tell your doctor right away.

How It Progresses

Telescoping fingers and toes do not happen overnight. The changes build up over time, but they can move quickly once they start. Here is what you might see as the condition progresses:

• Your fingers may start to shorten and bunch together. This is often called “telescopic fingers” or “opera glass hands.”
• The tissues that hold your joints together become weak. This makes it easy for the bones to collapse.
• You may find that you can pull or push your fingers, and they will stretch out or fold in, much like a telescope.
• Sometimes, your fingers move in directions they should not, making it hard to grip or hold things.
• The same changes can happen in your toes. This can make walking painful or difficult. You might need special shoes or supports.
• The disease usually affects the small bones in your hands and feet. The most common places are the joints at the ends of your fingers and toes.
• These changes can happen fast. Some people see big changes in just a few months or years after their first symptoms.

You may feel frustrated as your fingers or toes lose their normal shape and movement. The changes can make daily tasks much harder. Watching for these signs early can help you and your doctor find the best way to manage your symptoms.

Loss of Function

Limited Movement

You might see your fingers or toes do not move well. Arthritis mutilans can hurt your joints and bones a lot. This damage can change how your fingers look and work.

It gets hard to bend or straighten your fingers. Your joints may feel stiff or stuck in one spot. Sometimes, your fingers move oddly or feel loose, like they are not held tight.

When bone tissue breaks down, your joints can change shape. These changes make it tough to move your hands or feet. Over time, the problem can get worse.

You might lose more movement as the disease goes on. When bone and joint tissue break down, your fingers can get floppy or weak.

Here is a table that shows how movement loss in arthritis mutilans is different from other arthritis types:

Your fingers may get shorter and fold in, called “digital telescoping” or “opera-glass finger.” This makes it hard to use the joints that are hurt. The more the bones wear away or join together, the less you can move your fingers or toes.

If your fingers or toes do not move like before, or if they feel weak, tell your doctor. Getting help early can slow down movement loss.

Daily Challenges

Losing function in your hands or feet can make life harder. Simple things may be tough or not possible anymore. Many people with arthritis mutilans say pain and stiffness make daily tasks hard.

• You might have trouble brushing your teeth, making coffee, or opening doors.
• Holding a pen, using forks, or buttoning a shirt can be hard.
• Walking can hurt if your toes are affected, and you may need special shoes.

When bones in your fingers or toes break down and get shorter, it is hard to use your hands for daily things. Joint changes can make gripping or holding objects tough. Some people see their fingers bend in strange ways, so picking up small things is hard.

People with arthritis mutilans for a long time often see big changes in their lives. Many say they cannot do self-care or daily things without help. Some people stop working early or take sick leave because of this. People between ages 45 and 60 often have the most trouble with daily life.

• You may need help getting dressed, bathing, or cooking.
• Some people use special tools to make things easier.
• Losing independence can be just as hard emotionally as it is physically.

Write down which tasks are hard for you. Show this list to your healthcare provider. They can help you find tools or therapies to make life easier.

Symptom Progression

Worsening Over Time

You may notice that symptoms of arthritis mutilans do not stay the same. They often get worse as time passes. At first, you might see mild swelling or pain in your fingers or toes.

Over months or years, these signs can become much more severe. Your joints may start to look different. Fingers or toes can shorten and bend in odd ways. You might lose the ability to move them as you did before.

Many people find that pain increases as the disease progresses. Swelling can last longer and become harder to control. You may see more joints affected over time.

Simple tasks like holding a cup or tying shoes can become difficult. Some people feel frustrated because they cannot do things they once enjoyed.

Keep a journal of your symptoms. Write down when you notice new changes or when old symptoms get worse. This helps your doctor understand how your condition is changing.

Impact on Joints

Arthritis mutilans causes major changes inside your joints. The damage does not just affect how your hands or feet look. It also changes how your joints work.

Imaging studies, like X-rays or MRIs, help doctors see these changes. They show how the disease breaks down bone and cartilage.

Here is a table that shows what imaging studies often find in people with this condition:

You may see your joints lose their normal shape. The space between bones can shrink until the bones touch or even fuse together.

This process, called joint space narrowing, often leads to more pain and less movement. Bone remodeling means your bones break down and try to rebuild, but the new bone is often weak or in the wrong place.

These changes can cause your fingers or toes to collapse or shorten. You might notice that your joints feel loose or unstable.

Sometimes, the bones fuse together, making it impossible to move the joint at all. Doctors rely on imaging to watch how fast these changes happen and to plan your treatment.

 

If you notice new joint changes or more pain, tell your doctor. Early action can help slow down joint damage.

Differences from Other Types

Unique to Arthritis Mutilans

You might wonder how arthritis mutilans is different from other arthritis. Some signs only show up in this condition. You will notice changes that do not happen in most other types.

The biggest differences are severe bone loss and digital shortening. These changes affect your hands and feet in ways you can see.

Doctors call the bone loss “osteolysis.” This means the bone in your fingers or toes breaks down and goes away. Your fingers may get much shorter.

This does not happen in regular psoriatic arthritis or rheumatoid arthritis. The joints can fall apart, and your fingers may look like a telescope opening and closing. These changes are rare in other types.

Tip: If you see your fingers getting shorter or your joints falling apart, talk to your doctor. These signs are special to arthritis mutilans.

Comparison Points

Some symptoms show up in other types of arthritis, but they are not as strong or damaging. Most people with psoriatic arthritis or rheumatoid arthritis have pain, swelling, and stiffness. These symptoms can make life hard, but they do not cause as much damage.

Here are some things that make arthritis mutilans different:

• Severe osteolysis in the joints of the hands and feet
• Digital shortening that leads to finger deformities
• Mainly affects the joints in your hands and feet

In regular psoriatic arthritis, you may have swollen fingers or toes. You might see some joint damage, but your bones do not break down as much.

Rheumatoid arthritis can cause joints to look odd, but it does not make fingers or toes telescope. Your fingers do not get shorter in these other types.

Doctors use these signs to tell arthritis mutilans apart. They look for bone loss and digital shortening. These features help them make the right diagnosis. You should know that these changes are not common in other types of arthritis.

Write down your symptoms to help your doctor figure out what kind of arthritis you have. If you see big changes, you might have arthritis mutilans.

Diagnosis Challenges

Delayed Recognition

Doctors do not always find arthritis mutilans quickly. This disease can hide behind other joint problems. Many people first feel pain or swelling.

These signs look like other types of arthritis. Sometimes, you do not have skin symptoms when joint pain starts. This makes it hard for your doctor to link your pain to arthritis mutilans.

Several things can slow down diagnosis:

• Doctors may not think of arthritis mutilans if you do not show psoriasis.
• You might wait months before seeing a rheumatologist after symptoms begin.
• Joint damage can start before you get a clear diagnosis.
• Usually, psoriasis comes before arthritis, but the gap can be long—about 11 years on average.

Waiting six months or more after symptoms start before seeing a rheumatologist can cause more joint damage and worse long-term movement.

You may feel upset if your symptoms do not match the usual signs. Some people see many doctors before getting the right answer.

Early signs, like mild swelling or pain, may not seem serious. Over time, the damage gets worse, and you may see your fingers or toes change shape. By then, joint damage may have already begun.

Doctors use your medical history, a physical exam, and imaging tests to help find the diagnosis. If you have family members with psoriasis or joint problems, tell your doctor. Keeping a record of your symptoms and changes can help speed up diagnosis.

Overlap with Psoriatic Arthritis

You may wonder how arthritis mutilans connects to psoriatic arthritis. These two diseases share many signs. Arthritis mutilans often happens in people who already have psoriatic arthritis.

About 5% to 16% of people with psoriatic arthritis get this severe form. You may see big changes in your fingers or toes, like telescoping digits and bone loss, called osteolysis.

Here are some important facts about the overlap:

1. Arthritis mutilans usually shows up in people with psoriatic arthritis.
2. This form causes strong joint damage, mostly in the small joints of your hands and feet.

You may notice that both diseases can look very similar. Both can cause swelling, pain, and stiff joints. Doctors sometimes have trouble telling them apart, especially early on. Imaging tests may show bone loss in both, but the damage is much worse in arthritis mutilans.

Studies show there is often no clear line between types of psoriatic arthritis. You may have signs of both at the same time, like joint swelling, pain, and changes in your fingers or toes.

If you have psoriatic arthritis, watch for signs of worse joint damage. Shorter fingers or toes, or joints that collapse, may mean arthritis mutilans. Finding these signs early helps you and your doctor pick the best treatment to protect your joints.

You should watch for certain signs if you think you may have arthritis mutilans. Look for severe joint pain and swelling in your hands or feet. Notice if your fingers or toes become shorter or if the bones seem to disappear. Pay attention to nail changes, like thickening or discoloration, and skin lesions. If your fingers move in and out like opera glasses, seek medical advice. Early action helps protect your joints and daily life.

FAQ

What is arthritis mutilans?

Arthritis mutilans is a rare and severe form of arthritis. You see it most often in people with psoriatic arthritis. It destroys joints and bones, especially in your hands and feet.

What are the first signs you might notice?

You may first see swelling, pain, or changes in your fingers or toes. Your joints might look different or feel stiff. Sometimes, your fingers start to look shorter.

What makes arthritis mutilans different from other arthritis types?

You see more bone loss and digital shortening in arthritis mutilans. Your fingers or toes may collapse or telescope. These changes do not happen in most other arthritis types.

What does “telescoping fingers” mean?

Telescoping fingers means your finger bones collapse. Your fingers look shorter and can move in and out, like a telescope. This sign is unique to arthritis mutilans.

What can you do if you notice these symptoms?

You should talk to your doctor right away. Early treatment helps slow joint damage. Keep track of your symptoms and changes in your hands or feet.

What tests help diagnose arthritis mutilans?

Doctors use X-rays, MRIs, and physical exams. These tests show bone loss, joint changes, and digital shortening. Your doctor may also ask about your family history.

What happens if you do not treat arthritis mutilans?

You may lose movement in your fingers or toes. Daily tasks become hard. The damage can get worse over time. Early treatment helps protect your joints.

What support can help you manage daily life?

You can use special tools, therapy, or support from family. Occupational therapists can teach you new ways to do daily tasks. Support groups help you share your experience.