Understanding Positive Ulnar Variance in RA
I am a 40-year-old woman diagnosed with rheumatoid arthritis (RA). My journey began in 2012 when I experienced my first significant flare-up, which persisted for nearly a year. Remarkably, I managed to maintain a state of being asymptomatic for almost a decade without any medication during that time. However, after giving birth to my first child in 2022, I noticed a resurgence of symptoms, characterized by heightened inflammation and frequent, painful flare-ups. Currently, I am on Rinvoq, having started the treatment ten months ago. Despite this, I have found myself needing prednisone on six different occasions which I've had to take to manage the debilitating swelling, especially in my hands and wrists. Recently, I underwent an X-ray of my hands and wrists. Unfortunately, I won’t see my rheumatologist until October, but the X-ray results indicated that I have bilateral positive ulnar variance in my wrists. I'm unsure about the implications of this finding and how it connects to my condition of RA. I hope to gain a better understanding of this variance and its relevance to my ongoing health challenges.
Answers (1)
7/26/2025, 2:10:41 PM
OpenHealth AI
Understanding Positive Ulnar Variance in RA
Positive ulnar variance indicates that the ulna bone in your forearm is longer relative to the radius, which can place increased stress on the wrist joint and potentially lead to pain or degenerative changes. This finding is particularly relevant for someone with rheumatoid arthritis (RA), as RA can already cause inflammation and damage to joints.
Explanation: In simple terms, having a positive ulnar variance means that the ulna bone is positioned slightly differently compared to the radius. In healthy wrists, these bones work together without causing excessive stress on the joint surfaces. However, with RA, the inflammation you are experiencing can exacerbate any existing conditions, such as positive ulnar variance, increasing the risk of wrist pain or discomfort.
Understanding these terms can help you manage your symptoms better. While this variance needs attention, it doesn’t change the overall approach to treating RA. It's crucial to address both your ulnar variance and the flare-ups you're experiencing.
Next Steps:
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Monitor Symptoms: Keep a detailed diary of your symptoms, noting when you experience pain or swelling in your wrists and hands, as well as any triggers you identify. This can help inform your treatment plan.
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Incorporate Joint Protection: Consider using wrist splints during activities that aggravate your pain. These splints can help reduce strain on your wrist by immobilizing the joint slightly.
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Optimize RA Management: Stay on your current medication regimen, including Rinvoq. Discuss with your healthcare provider the frequency of prednisone use, as relying on it may indicate that your RA is not fully controlled.
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Gentle Stretching and Strengthening Exercises: Engage in low-impact exercises designed for individuals with RA. These exercises can help maintain wrist function and strength without exacerbating inflammation.
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Stay Informed: When you see your rheumatologist in October, discuss the impact of the positive ulnar variance on your treatment plan. They may recommend imaging or adjustments to your current medications based on your symptoms and the X-ray results.
By taking these steps, you'll be better equipped to manage both your RA and any complications related to the positive ulnar variance. If you have any further questions or concerns, feel free to reach out again!
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