What is a common indication for boutonniere deformities?

Boutonniere deformity is primarily associated with rheumatoid arthritis due to the pathophysiological changes that occur in the joints and surrounding structures. In rheumatoid arthritis, inflammation affects the synovial membrane, leading to joint damage and alterations in the volar plate and the central slip of the extensor tendon. This results in the characteristic flexion of the proximal interphalangeal (PIP) joint and hyperextension of the distal interphalangeal (DIP) joint, forming the boutonniere deformity.

This deformity is less commonly seen in osteoarthritis, gout, or psoriatic arthritis, as these conditions do not typically cause the same extensive inflammatory joint changes or tendon and ligament dysfunction that characterizes rheumatoid arthritis. For example, osteoarthritis is primarily a degenerative joint disease rather than inflammatory, while gout is related to uric acid crystal deposition rather than synovial inflammation. Psoriatic arthritis can affect the digits and lead to dactylitis or other joint issues, but it is not as strongly linked to boutonniere deformities as rheumatoid arthritis is. Thus, the association of boutonniere deformity with rheumatoid arthritis is well-established in clinical practice.