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Osteoarthritis of the Hand


Arthritis, or joint inflammation, occurs when the cartilage that normally covers the joint surfaces and allows them to glide smoothly “wears out.”  Arthritis can occur in any joint in the body, but is very common in the hand and wrist and can bother you even during seemingly easy activities like writing or opening jars!  Osteoarthritis, post-traumatic arthritis, and rheumatoid arthritis are the most common arthritic conditions in the hand.

The most common sites of osteoarthritis in the hand are at the base of the thumb and at the middle and last joints of the fingers.  Symptoms you might feel are swelling, stiffness, and pain.  Bony nodules or “bumps” can develop at the affected joint(s).  Diagnosis is made by physical examination and x-rays.

The goal of treatment is to relieve the pain and restore function of the hand.  Anti-inflammatories can help relieve pain from inflammation.  Periods of rest and splinting might be beneficial as well.  Heat modalities like paraffin might help; cold can be helpful if you have considerable swelling.  Maintaining motion is key, and hand therapy might help restore or maintain your function and relieve symptoms.  Steroid injections can decrease inflammation temporarily.

If conservative treatment fails (too much pain or too little function), surgery can be an option.  Joint fusion (making the bones fuse together, which means that the joint will not hurt because the joint will not move anymore) or reconstruction can be performed.  Your hand surgeon can help determine if theses are options for you.

 

This patient had multiple finger joints with severe arthritis and over time, had all of these joints fused.  Her fingers cannot move at these joints but her pain is relieved and her hands function well.


A mucous cyst formed at this joint near the nail plate because of arthritis.  Treatment involves debridement, or “cleaning up” the arthritis in the joint, which leads to resolution of the cyst.