Abstract
1. One hundred and twenty-six metacarpo-phalangeal joints affected by rheumatoid arthritis were studied macroscopically at either synovectomy or arthroplasty.
2. The sites and extent of the initial erosion corresponded with the sites and size of the synovial pouches.
3. The areas of cartilage degeneration were related to the degree of flexion, ulnar deviation and subluxation of the proximal phalanx on the metacarpal head.
4. The routine radiographic findings were not a true reflection of all the pathological changes within the joint.
5. It is suggested that by encouraging joint movement and preventing deformity the degree of cartilage degeneration may be diminished.
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