TREATMENT OF WRIST AND METACARPAL PHALANGEAL JOINT EFFUSION RELATED TO RHEUMATOID ARTHRITIS WITH THERAPEUTIC ULTRASOUND: A CASE REPORT
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Abstract
Objective: To discuss the management of a patient with rheumatoid arthritis treated with therapeutic ultrasound and chiropractic interventions.
Clinical Features: A 32-year-old female with rheumatoid arthritis complained of bilateral wrist and hand stiffness along with joint effusion. She was also seeing her rheumatologist, who prescribed methotrexate. She had decreased grip strength and difficulty holding heavy objects in her hands.
Intervention and Outcome: She had been coming into the clinic for approximately 2 years to recieve high-velocity low-amplitude adjustments to her wrists, thoracic and lumbar spine and both sacroiliac joints. Therapeutic ultrasound to her wrists was added to her treatment plan while eliminating the wrist adjustments. She was treated over the course of 8 weeks with 1 treatment per week. The ultrasound was performed for 3 minutes at 0.6 watts/cm2, with a 50% duty cycle to both wrists and the 1st and 2nd metacarpal phalangeal joints. Her grip strength, and pinch grip test improved and her joint effusion decreased.
Conclusion: Therapeutic ultrasound helped control this patient’s wrist and hand. (Chiropr J Australia 2017;45:229-235)
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