Rheumatic or degenerative diseases can cause deformities in the joints, including the hands and fingers. Diseases such as various types of arthritis, osteoarthritis, or Paget’s bone disease, as well as chronic consumption or high doses of corticosteroids (prednisone, cortisone, betamethasone, dexamethasone), can lead to deformation in the hands and fingers.
When the joints of the hands and fingers undergo deformation, they lose the ability to move freely and become especially painful. Additionally, the aesthetic appearance of the hands is affected, impacting the self-esteem of the person.
There are various therapeutic modalities to address these problems, such as arthroscopic surgery and partial or total joint replacement, which are surgeries for hands with arthritis. The treatment of functional disability in hands and fingers with arthritis often involves a surgical procedure.
Rheumatic Pathologies of the Hand
The main rheumatic pathologies causing deformation and loss of function in the hands, wrists, and fingers are rheumatoid arthritis and osteoarthritis. Their major symptoms include joint pain and inflammation. When conservative treatment for arthritis in hands and fingers (exercises and medications) is ineffective, we can resort to joint replacement.
- Rheumatoid Arthritis: This is a form of arthritis in which the structures of the hands, tendons, soft tissues, and joints become inflamed, causing pain and joint destruction or deformity. In more severe cases, functional disability can occur. Correction is only possible through hand and finger surgery for arthritis.
Osteoarthritis: Also called degenerative arthritis, it causes alterations in joint cartilage and surrounding tissues, resulting in pain, inflammation, joint stiffness, and over time, loss of function.
Thumb Base Wear and Tear
In healthy joints, cartilage covers the bones to provide a smooth surface for easy movement. However, it can be worn down by continuous use throughout life or injured by traumatic processes such as fractures.
Osteoarthritis occurs when the cartilage has worn down and causes friction between the bones that form the joint. In the hand, osteoarthritis most commonly occurs at the base of the thumb.
Thumb Arthritis or Base Wear and Tear is called rhizarthrosis, where the joint is formed by the trapezium and metacarpal bones of the thumb.
Symptoms
The symptoms of rhizarthrosis are more common in women than in men and usually occur after the age of 40, although it can appear before this age if there are injuries in the thumb area.
Symptoms include pain at the base of the thumb when gripping the hand forcefully or when pressing down on objects, such as opening jars, turning doorknobs or turning a key. Some people perceive a sensation of rubbing or snapping when moving the thumb and often describe it as pain in the thumb.
A person with rhizarthrosis may experience a progressive decrease in the strength of the thumb to apply pressure. In severe cases, the joint dislocates, causing deformity of the thumb.
Diagnosis and Treatment
To diagnose rhizarthrosis, a physical examination of the hand and thumb is necessary, as well as an analysis of the patient’s symptoms. X-rays are taken to observe if there is a reduction between the bones of the joint and to confirm the diagnosis. Sometimes, the formation of spurs around both bones can be observed.
For mild to moderate cases, treatment involves immobilizing the thumb with a splint and controlling pain and inflammation with oral medications. Occasionally, local steroid injections may be used. If the condition is very severe or there are persistent symptoms, surgery is the best solution.
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