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ARTHRITIS OF THE HAND AND WRIST Arthritis occurs when the cartilage that provides the cushion between bones of a joint wears away. This leads to pain and stiffness in the affected joint. While any joint can be affected, some of the most common problems people seek attention for include: Distal interphalangeal joint- at the last knuckle of the finger. Pain, stiffness and deformity may occur. Often people may also develops fluid filled cysts over these knuckles as a result of the arthritis. Initial treatment included anti inflammatory medications. If draining cysts develop, surgery may be needed to excise the cyst and remove bone spurs. In cases of severe arthritis, the joint may need to be fused. Proximal interphalangeal joint- at the middle knuckle of the finger. Pain, stiffness and deformity may occur. Initial treatment includes anti inflammatory medications or steroid injections. In cases of severe arthritis, the joint may need to be replaced or fused. Joint replacement is performed with a silicone implant after the arthritic bone is removed. Joint fusion is performed by removing the arthritic bone and having the ends of the bone heal to each other leaving a stiff, but stable and painless joint. Metacarpophalangeal joint- at the first knuckle of the finger. Pain, stiffness and deformity may occur. Initial treatment includes anti inflammatory medications or steroid injections. In cases of severe arthritis, the joint may need to be replaced or, in the case of the thumb, fused. Thumb CMC- at the base of the thumb. Symptoms include pain at the base of the thumb, stiffness, and weakness in gripping activities such as opening a jar. Initial treatment includes splinting, anti-inflammatory medications and steroid injections. If pain persists, surgery to remove the arthritic bone and restore stability by reconstructing the ligaments can be performed. Scapholunate advanced collapse (SLAC wrist)- in the wrist. It is a result of failure of the ligament that keeps two of the small bones of the wrist in the correct alignment. As the bones settle into their new positions, arthritis can spread throughout the wrist. Symptoms include wrist pain, stiffness and weakness. Initial treatment includes splinting, anti inflammatory medications and steroid injections. A variety of surgical interventions are available depending on the severity of the arthritic changes. The image below is from the American Society for Surgery of the Hand. Click below to go to their pages dealing with arthritis of the hand and wrist. Hand Arthritis
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