INTRODUCTION

Thumb arthritis is common with aging, and occurs when cartilage wears away from the ends of the bones that form the base of the thumb joint also known as the carpometacarpal joint.

SYMPTOMS

The most common symptom is pain at the base of the thumb. The pain can be aggravated by activities that require pinching, such as opening jars, turning door knobs or keys. Severity can also progress to pain at rest and pain at night. In more severe cases, progressive destruction and mal-alignment of the joint occurs, and a bump develops at the base of the thumb as the metacarpal moves out of the saddle joint. This shift in the joint can cause limited motion and weakness, making pinch difficult.

DIAGNOSIS

The diagnosis is made by history and physical evaluation. Pressure and movement such as twisting will produce pain at the joint. A grinding sensation may also be present at the joint. X-rays are used to confirm the diagnosis, although symptom severity often does not correlate with x-ray findings.

TREATMENT

Initial thumb arthritis will usually respond to non-surgical care.

Arthritis medication, splinting and cortisone injections may help alleviate pain. A hand therapist might provide a variety of splints which can be used while sleeping or during activities.

Patients with advanced disease or who fail non-surgical treatment may be candidates for surgical reconstruction. A variety of surgical techniques are available that can successfully reduce pain. Surgical procedures include arthroplasty, joint fusion, and other techniques such as the use of a “tight rope” procedure…

CASE 1

  

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CASE 2