Introduction
Anatomy
Causes
Symptoms
Diagnosis
Non-operative treatment
Operative treatment
Osteoarthritis is a degenerative joint disease, in which the cartilage covering bone surfaces of a joint is injured or wears over time. There are three common sites of osteoarthritis in the hand: distal inter-phalangeal joint, proximal inter-phalangeal joint and thumb carpal-metacarpal joint.
The distal and proximal inter-phalangeal joints are the joint near fingertip and the middle joint of a finger respectively. Thumb carpal-metacarpal joint is located at the base of thumb near the wrist.
The common causes of osteoarthritis of hand are: injury, repetitive wear and tear, infection or inflammatory joint diseases.
Osteoarthritis of hand can cause stiffness, swelling, pain and deformity. Bone spur or cyst (mucus cyst) may form on the dorsal side of finger joint. In addition to pain over thumb base, osteoarthritis of thumb carpal-metacarpal joint can cause weakness in pinching and gripping objects.
Diagnosis is made clinically and confirmed by X-rays of the hand. X-rays will show narrowing of joint space and bone spurs.
The goals of treatment are pain relief and restoring function. Doctors will offer non-operative treatment first by means of painkillers, anti-inflammatory drugs, physiotherapy, occupational therapy and hand splints. Doctors may also suggest steroid injection into the joint to relief pain and control inflammation but this will not cure osteoarthritis.
If symptoms deteriorate despite non-operative treatment, operative treatment could be considered. One common method is joint fusion. The joint will be fused in a functional position to achieve a pain-free but immobile joint. Another method is joint reconstruction (arthroplasty) by replacing the destroyed joint surfaces with your own soft tissue or implants.