A 76-year-old woman with rheumatoid arthritis comes to the office because of a 2-month history of difficulty flexing the index finger of the left hand. She says that when she flexes the finger, a painful snapping sensation occurs. Physical examination shows fullness of the flexor tendon at the level of the A1 pulley. Which of the following is the most appropriate surgical treatment?  

A 60-year-old woman with a history of rheumatoid arthritis presents with a boutonnière deformity of the long finger. Which of the following is the most likely cause of the deformity? 

A 57-year-old right-hand–dominant woman with rheumatoid arthritis presents with 10/10 pain of the right thumb that is preventing her from painting, her primary activity. X-ray study shows rheumatoid changes in multiple joints; right thumb carpometacarpal (CMC) joint is consistent with Eaton stage 3-4 disease. On physical examination, the right thumb metacarpal base is prominent. Grind test result is positive. Which of the following is the most appropriate management to help this patient resume her normal activities? 

A 64-year-old woman with rheumatoid arthritis is evaluated for abrupt onset of inability to extend the ring and little fingers of the left hand. Surgical exploration confirms attritional tendon rupture and caput ulnae syndrome. In addition to tendon reconstruction, which of the following interventions is most likely to prevent recurrence of this condition? 

A 65-year-old woman comes to the office because she is unable to actively extend the left ring and small fingers. Medical history includes rheumatoid arthritis and no marked trauma. On physical examination, the ring and small fingers are held in 45 degrees of flexion with ulnar deviation at the metacarpophalangeal (MCP) joints. Mild swelling around the MCP joints of all fingers and a prominent ulnar head are noted. The patient is able to maintain extension when her fingers are passively extended. X-ray studies show moderate to severe wrist arthritis but minimal arthritic changes of the finger joints. Which of the following best explains the physical examination findings in this patient?