Introduction Rheumatoid Arthritis (RA) is an autoimmune disorder that pro- duces persistent infammatory joint symptoms throughout the body. *Corresponding author: Tarek M El-Gohary, Department of Physical Therapy, College of Medical Rehabilitation Sciences, Taibah University, Saudi Arabia, Tel: +966 0545007025; E-mail: dr.elgoharyt@yahoo.com Citation: El-Gohary TM, Abd Elkade SM (2019) Hands Function and Rheu- matoid Arthritis: Case Report and Rehabilitation Outcomes. J Clin Stud Med Case Rep 6: 063. Received: January 12, 2019; Accepted: February 04, 2019; Published: Feb- ruary 19, 2019 Copyright: © 2019 El-Gohary TM and Abd Elkade SM. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. RA is chronic non-curable systemic infammatory disease with ear- ly symmetrical but unpredictable symptoms. RA has a rather rapid onset where early clinical manifestations most frequently located in the small joints of the hands [1]. RA is a complex systemic disease, if left untreated, can worsen in a matter of weeks. RA can progress differently in each patient. Therefore, rehabilitation should be tailored to suit every patient’s sufferance. RA has no specifc etiology and it is not uncommon for patients to suffer a relapse while being under physical rehabilitation [2,3]. Patients with RA must be carefully mon- itored as they experience cycles of relapse [2,3]. The rheumatologist has to control symptoms using medications. Rehabilitation clinicians and physical therapists have to control symptoms and improve func- tional capacity using rehabilitation measures. Unfortunately, there is weak evidence and uncertainty to support using cold applications and hand exercises to control symptoms and improve functional ability of hands [4]. We hypothesize that early physical therapy intervention and participating in individualized hand exercise programme, within the limits of physical capacity, could slow down disease progression and improve functional ability of hands. Reviewing of related literature showed that there is no previously published case report discussing clinical presentation and rehabilitation progression of disabled hands in patient with RA. The present report describes an untraditional case presenting in a male patient formerly diagnosed with RA that devel- oped fare up of symptoms along with muscular and osteoarticular complications of both hands. Case Report A 46- year old, right hand dominant Saudi male patient with 3 years history of Rheumatoid Arthritis (RA) presented with a fare up of symptoms at both hands. Symptoms primarily were synovitis, swelling, pain, lack of power and increased heat at both hands. Patient was diagnosed with RA 3 years ago by rheumatologist. Patient started physical therapy rehabilitation program since he was diagnosed but he has been inconsistent with the rehabilitation particularly when he has symptoms under control. Patient indicated a past history of gen- eral body ache, low grade fever, deconditioning, fatigue, grossly re- stricted mobility in addition to lack of appetite for a two weeks before being diagnosed. Patient was frst seen by internist who prescribed some analgesics and anti-infammatory that did not help much. Morn- ing stiffness and fatigue were his chief complaint. The rheumatologist requested all necessary investigations and confrmed the diagnosis of RA. Patient has positive family history given that his grandmother was diagnosed with RA. Patient presented, at this episode, with swelling of both knees and hands but for the purpose of discussion we will mainly focus on hands function and rehabilitation potential. The orthopedic clinical specialist who provides physical therapy and rehabilitation immediately referred the patient to the rheumatologist to monitor and control the fare up and exclude any new systemic diseases. The rheumatologist conducted all necessary investigations and adjusted the medications accordingly. Patient is currently taking disease-modifying anti-rheumatic drugs. The patient did not report any recent history of trauma. Patient reported that he has all over body ache, restricted mobility and poor functional capacity. Patient had poor posture in terms of mild stooping posture. Patient had pain severity of 3-4/10 at both hands which is getting worse. Pain is 2/10 El-Gohary TM and Abd Elkade SM, J Clin Stud Med Case Rep 2019, 6: 063 DOI: 10.24966/CSMC-8801/100063 HSOA Journal of Clinical Studies and Medical Case Reports Case Report Tarek M El-Gohary 1,3 * and Samiha M Abd Elkade 2 1 Department of Physical therapy, College of Medical Rehabilitation Sciences, Taibah University, Saudi Arabia 2 Department of Rehabilitation Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia 3 Department of Biomechanics, Cairo University, Egypt Hands Function and Rheumatoid Arthritis: Case Report and Rehabilitation Outcomes Abstract Introduction: Rheumatoid arthritis is an autoimmune disorder which starts in the joints of the hands and feet with symptoms of warm, stiff and swollen joints. This case report purported to details the clinical presentation and rehabilitation outcomes of a case of Rheumatoid Arthritis causing severe functional disability of hands. Case report: The study subject was 46-year-old Saudi male with 3 years history of Rheumatoid Arthritis. Patient received medical care and rehabilitation. Physical therapies to control symptoms, in addi- tion to exercise therapy as tolerated, using the sponge ball, were the main interventions. The patient showed decrease in joints pain, synovitis and tenderness. Hand grip strength and Key pinch strength showed signifcant (p<0.05) improvement at 5 weeks of exercises. Patient has shown more independence with activities of daily living. Health assessment questionnaire disability index dropped from 1.7 to 0.9 which refects improvements. Discussion/Conclusion: The patient was slowly but fairly respond- ing to physical& exercise therapy. Sponge soft ball is convenient tool to be used by patients with rheumatoid arthritis for improving hands functional capacity. Keywords: Hands exercises; Rehabilitation outcomes; Rheumatoid arthritis.