Arthritis
Causes
The joints can be affected by arthritis from many different causes. They include but are not limited to:
Osteoarthritis, which is routine wear and tear
After an injury, which could include a broken bone where the crack extends into the joint
Certain medical conditions (rheumatoid arthritis, gout and pseudo-gout, psoriasis, etc.)
Infections, often after a cut, puncture or animal bites where bacteria are introduced into the joint and cause rapid cartilage injury
Signs and Symptoms
Arthritis may cause pain, loss of motion, and swelling. These changes often come on gradually and may not be noticed right away. These symptoms may feel worse when gripping or grasping, such as when turning a key or opening a jar. Patients with arthritis sometimes have weak hands and may tend to drop objects due to sudden pains.
Over time, the fingers may shift toward the pinkie, which is called an ulnar drift.
Seek urgent medical attention if there is a deep cut or puncture over a joint, especially if the joint becomes very painful or swollen, has fluid leaking out, if moving the joint is extremely painful, or if motion is very limited.
Diagnosis
The diagnosis of arthritis is often confirmed by taking x-rays. Figure 3 is an x-ray of a hand with arthritis. The x-ray shows narrowing of the space between the bones, which is a sign that cartilage has been lost. Your doctor may also order blood tests or imaging studies to confirm the diagnosis.
Treatment
There are many treatments available depending on the amount of pain and loss of function. Oral medication can be very helpful in relieving pain. Sometimes steroid injections into the joint can help. Other options include:
Skin creams
Heat or ice
Splints
Supports, such as buddy strapping two fingers together
Hand therapy can help maintain motion and strength.
If medical treatment fails, then surgery can be considered. There are many surgical options depending on the type and severity of arthritis. If the arthritis is extensive and severe, joint replacement or joint fusion are effective surgical options.
Not everyone is a good candidate for surgery. Discuss your treatment options with your hand surgeon.