Osteoarthritis of the Hand
Osteoarthritis, also called degenerative arthritis, is a degenerative condition that commonly affects the small joints of the fingers and the base of the thumb. Common in both men and women, it can cause the joints to become swollen, stiff and painful. It often leads to joint enlargement, interfering with normal hand function and significantly impacting a person's quality of life. There are two main types of hand arthritis: primary generalized osteoarthritis and erosive osteoarthritis, and they affect the hands differently.
This condition is primarily caused by aging, but gender, heredity, and repetitive joint stress also are factors. As our bodies age, the cartilage that lines the ends of our bones begins to weaken and can wear away. In the joints, where the ends of the bones meet and rub against each other, this loss of cartilage can lead to inflammation and pain. Eventually, the cartilage may completely degenerate, allowing bone to rub directly against bone. This causes further pain and difficulty with motion.
Symptoms of primary generalized osteoarthritis include pain, swelling and stiffness in the finger joints nearest the nail and the base of the thumb. This pain is most noticeable during and after activity, but as the condition worsens, pain may be felt even during periods of limited activity. Cysts may also develop at the joints nearest the fingernails. Called mucous cysts, this type of ganglion cyst may cause the overlying skin to thin, or it may cause a groove to develop in the nail. Symptoms of erosive osteoarthritis include pain and swelling and boney erosions in the middle joints of the fingers. The thumb is not commonly affected. Joint deformity may develop as arthritis progresses.
Treatment options include cortisone injections, non-steroidal anti-inflammatory medications, use of a splint or brace, exercise, and modification of daily activities. In severe cases, surgery may be needed to fuse or replace the joints. If mucous cysts have formed, they may need to be excised to prevent rupture or alleviate pain or nail deformity.
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