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Beverly Hills
9301 Wilshire Boulevard
Beverly Hills, California 90210
West Hills
7301 Medical Center Drive
West Hills, California 91307
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Osteoarthritis of the Hands & Fingers
Types of Osteoarthritis
Common Areas Affected in the Hand
Signs & Symptoms
Diagnosis of Osteoarthritis
Non-Surgical & Surgical Treatments
Each hand is made up of nineteen major bones, eight small ones, and
two from the forearm that make up the wrist. At the point where the
bones meet, a joint is formed that is usually composed of two smooth
surfaces covered with cartilage that work as a unit. Arthritis, which
literally means "inflamed joint," occurs when the surfaces
of these joints no longer line up perfectly.
| Types of Osteoarthritis |
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While arthritis can painfully disable any joint in the body, when
it presents itself in the hand or in fingers it feels rather serious
because those joints are used so often. Arthritis can come from infections,
gout, and psoriasis, but the most common forms are osteoarthritis,
rheumatoid
arthritis, or post-traumatic arthritis, which is caused by an
injury.
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| Common Areas Affected in the Hand |
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When the cartilage that covers the surfaces of the bones in any joint
begins to wear out, it is referred to as osteoarthritis. Osteoarthritis
is a degenerative joint disease that presents itself from overuse
of the joints or because of an injury to the joint. Osteoarthritis
typically presents itself in the wrist. However, with respect to the
hand, it often shows up in one of three places:
In the trapezio-metacarpal or basilar joint, where the thumb meets
the wrist
In the distal interphalangeal or DIP joint, closest to the end of
the finger
In the proximal interphalangeal or PIP joint, in the middle of
the finger
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| Signs & Symptoms |
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No matter the type, arthritis causes the joints to be stiff, swollen,
and painful. In the case of osteoarthritis in the middle of the
finger (i.e., the PIP joint) bony nodules called Heberden's nodes
may present themselves. If osteoarthritis is in the joints near
the fingertips (i.e., the DIP joints), the nodules are called Bouchard's
nodes.
If the basilar joint, at the base
of the thumb, has osteoarthritis, a deep aching pain is usually
felt in the joint. The joint may, in addition, show swelling or
a bump. Osteoarthritis often results in a weakened pinch or grip,
so turning keys or opening jars may be difficult. If the joints
in the wrist have osteoarthritis, wrist strength may be affected,
and the wrist may be painful to move, stiff, or swollen.
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| Diagnosis of Osteoarthritis |
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To see if you have osteoarthritis, your hand surgeon will do an
examination of your joints. The appearance of your hands and fingers
will be checked, and x-rays may be taken to see if the space between
the joints has shrunk or if bony outgrowths in the form of nodes
or osteophytes have formed. X-rays can also indicate whether the
bones near the ends of the joints have begun to form denser areas
of harder bone.
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| Non-Surical & Surgical Treatments |
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The goal of any treatment for hand or finger osteoarthritis is to
eliminate pain so as to facilitate the ability to resume daily activity.
To reduce the pain, anti-inflammatory or analgesic medicines may
be used. Additionally, brief periods of rest for the affected joints
may help if there is an occasional flare up of symptoms. The use
of wrist or finger splints may help. The use of splints is not an
option, soft sleeves may be used.
Heat treatments using warm wax or paraffin can sometimes help with
the pain or stiffness. However, if the swelling is excessive, cold
packs may be applied. The goal in any treatment is to keep the fingers
and joints in the hand as flexible as possible so that they can
be fully functional once again. With proper therapy, exercise, splint
use, and hot or cold treatments, it is often possible to resume
typical activity.
In more severe cases, cortisone may be injected. While this relieves
the symptoms, it does not cure the arthritis. When the before mentioned
treatments fail to provide relief, surgery is considered.
If the amount of pain is too great, or if the arthritis is keeping
the hand or fingers from being used, your hand surgeon may suggest
surgery. The goal of surgery would be to restore the use of the
hand and eliminate or reduce the pain.
There are two types of surgical procedures used to treat osteoarthritis
in the hand or fingers. There is joint fusion, a procedure that
involves removal of the surfaces of the joints that have arthritis
are removed. This surgery results in the joint losing all ability
to move or bend, but it can eliminate pain and also fix any deformities.
The other surgery is joint reconstruction which involves removing
the face of the joint that is no longer smooth. The purpose of this
procedure is to get rid of the rough and irregular contact between
the bones that causes pain and limits the joint's ability to move.
After removing the bad part of the joint's surface, either a joint
replacement is implanted or the joint is lined with other soft tissue,
such as a tendon.
The type of surgery that will work best for your case depends on
which joint needs treatment. One of our hand surgeons will discuss
these matters with you fully, and help you decide the best way to
treat your hand or finger osteoarthritis.
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