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OSTEOARTHRITIS OF THE SMALL JOINTS OF THE HAND

In order to understand this condition it is important to understand the anatomy and function of the wrist and hand. Please read Wrist Pain Info / Hand Pain Info's sections on wrist anatomy and hand anatomy. For information on the biomechanics of the wrist and hand please read Wrist Pain Info / Hand Pain Info's section on wrist and hand biomechanics.

What is osteoarthritis?

The small joints in the hand are surrounded by a special type of tissue called a joint capsule. The capsule has a thin lining called the synovium which produces "synovial fluid". This fluid works to reduce friction and wear inside these small joints. The small joints of the hand are areas where the bones of the hand connect and where movement occurs. The "knuckles" as well as the thumb and finger joints are examples. Articular cartilage is a smooth shiny material that covers the ends of the bones inside the small joints of the hand. Inside the small joints of the hand there is articular cartilage anywhere that two bony surfaces come into contact with each other. Synovial fluid and healthy articular cartilage work together to allow bones to move easily and pain-free.

The word arthritis means inflammation (swelling) of a joint. Osteoarthritis is the term used to describe damage to articular cartilage inside joints. Osteoarthritis, also called "wear and tear" arthritis is the most common type of arthritis.

What is osteoarthritis of the hand?

The hand has 27 bones in it (including the small bones of the wrist). There are a number of small joints between these bones. As mentioned above, articular cartilage is the smooth coating that covers the surface of the bones inside these small joints. Osteoarthritis can affect the articular cartilage of any or all of these small joints.

In osteoarthritis the articular cartilage in the small joints of the hand begins to "wear out". Over time the articular cartilage can thin or form cracks. Tiny pieces of cartilage may come loose and float inside the small joints of the hand, further irritating the joint(s). After a longer period of time the cartilage can become completely "worn away" and the bones begin to rub together. The most common joints affected are the joints of the thumb and the last two joints of the fingers.

What does osteoarthritis of the hand feel like?

Osteoarthritis usually comes on slowly and results in pain, stiffness and/or swelling of the affected joints. Bumps or nodes may appear around the affected joints. When the joints are moved a grating sound may be heard. Sometimes the small joints of the hand can have a mild amount of osteoarthritis and feel perfectly fine.

What causes osteoarthritis of the hand?

No one knows for sure what causes osteoarthritis to develop in the small joints of the hand but some risk factors include:

  • Previous hand/wrist injury or fracture
  • Family history of osteoarthritis
  • Damage to the small joints of the hand from another type of arthritis such as rheumatoid arthritis or gout
  • Increasing age
  • Repetitive activity with hands and wrists over a period of time

Can osteoarthritis of the hand be detected on X-ray?

In some cases osteoarthritis of the hand can be diagnosed based on the medical history and physical examination of the affected joint(s). An x-ray may be ordered to determine how much joint damage there is. Sometimes blood tests or joint fluid tests are ordered to confirm the diagnosis or to distinguish between different types of arthritis. Other tests like bone scans or MRI's are not usually required.

What is the treatment for osteoarthritis of the hand?

Treatment options for the osteoarthritis of the small joints of the hand include exercises to improve range of motion and strength, medications to relieve pain and swelling, education on activity modification, heat/cold therapy, wrist or hand splints, injections and in some cases surgery. Doctors and physical therapists that deal with people who have osteoarthritis of the small joints of the hand can help outline a treatment program.

What other information is available on osteoarthritis of the hand?

The diagnosis and treatment of osteoarthritis of the small joints of the hand varies depending on the severity of the problem. Wrist Pain Info / Hand Pain Info's links section has additional information on osteoarthritis of the hand. Links have been provided to other websites as well as online medical journals. Visit Joint Pain Info for information on other joint injuries and problems.


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