Alignment of Musculoskeletal System in Systemic Lupus Erythematosus

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Abnormalities of joint alignment in systemic lupus erythematosus (SLE) are characterized by subluxation or dislocation without erosion. Hand deformities ("lupus hands") in SLE patients include ulnar deviation, swan neck deformity, and thumb Z deformity. However, abnormalities in alignment are widespread and can occur in the wrists, shoulders, hips, knees, toes, and spine. Osteonecrosis and fracture can also occur as alignment abnormalities. In addition, rheumatoid arthritis (RA) and other complications such as scleroderma and inflammatory myositis may also occur, making the alignment abnormalities complex. An understanding of alignment abnormalities in SLE is helpful in diagnosing the condition of the disease and establishing a treatment strategy. The purpose of this chapter is to provide an overview of alignment abnormalities in SLE from various perspectives.