What is arthritis of the hand?
Joints in the body are made up of the cartilage which is a cap at the end of the respective bones. This is bathed with nutrients secreted from the synovial cells on the lining of the capsule of the joint. There are supporting structures to the joints called ligaments. Due to a variety of causes, chronic inflammation occurs in the joint initially with eventually full blown arthritis with joint destruction.
What are the causes of arthritis of the hand?
- Traumatic: Fractures into the joint with or without anatomic reduction and ligamentous injuries can lead to abnormal shear forces across the cartilage and subsequent arthritis.
- Osteoarthritis: Wear and tear arthritis secondary to the aging process; the most common cause of non traumatic arthritis.
- Rheumatoid arthritis.
- Gouty arthritis.
- Septic or infectious arthritis.
What are the symptoms of arthritis of the hand?
- Swelling around the joint.
- Cyst formation.
- Pain with range of motion.
- Subluxation or instability of the joint.
How to diagnose arthritis of the hand?
In addition to a careful history of the symptoms described above, an examination will reveal:
- Tenderness well localized to the joint.
- Joint swelling.
- Palpable cyst.
- Joint deformity or deviation.
- Pain with limited range of motion.
- Compression of the joint produces discomfort.
- Excess deviation with stress of the joint and pain.
Additional tests may be helpful:
X-ray of the involved joint
Initially, widening of the joint space with soft tissue swelling and mild subluxation; further subluxation occurs with peripheral spur formation and calcification; later, joint space narrowing occurs with major joint subluxation.
ANA, rheumatoid factor, ESR, uric acid.
Non-surgical treatment of arthritis of the hand:
NSAID’s (i.e. Advil) or steroids; chemotherapeutic agents and gold therapy for patients with rheumatoid arthritis or other autoimmune diseases; therapy for stiffness; intra-articular Celestone injections occasionally; splinting.
Surgical treatment of arthritis of the hand:
Arthrodesis or arthroplasty depending on the joint involved and the physical demands put on the joint by the patient.
How can Dr. Knight help you with arthritis of the hand?
Dr. Knight has extensive experience in the treatment of arthritis of the hand. He will first confirm the diagnosis then provide conservative treatment to rapidly relieve or reduce your symptoms. In severe cases where you have pain with activities of daily living or pain at rest unrelieved with conservative care, surgery may be necessary. Based on your lifestyle and functional demands he will look at various options with you.
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