Basal thumb arthritis

Abstract

Basal thumb arthritis is a common condition seen in hand clinics across the United Kingdom and is often associated with other pathological conditions such as carpal tunnel syndrome and scaphotrapezial arthritis. Typically, patients complain of pain localised to the base of the thumb. This pain is often activity related, particularly after excessive use involving forceful pinch. A detailed history and examination is normally all that is needed to make the diagnosis. Provocative manoeuvres may be helpful in localising symptoms to the basal joint with degenerative changes or synovitis. Radiographs are useful for confirming the diagnosis and staging the disease in order to plan for surgery. The mainstay of initial treatment of basal thumb arthritis of any stage is activity modifications, rest, nonsteroidal anti-inflammatory drugs, exercises and splinting. A variety of surgical procedures are available to treat the condition when conservative measures have failed, in order to control symptoms and improve function. We review the current literature and discuss the clinical aspects of this condition, staging, and treatment options available, and the difficulties treating this group of patients.

Trapeziometacarpal joint contact varies between men and women during three isometric functional tasks

“…The TMC joint is susceptible to OA, and women are two to six times more likely to develop TMC OA compared to men [1–3]. Mechanical factors such as contact forces and contact area are likely to be important contributors to the onset, progression, and sex-disparity of TMC OA [4–6].…”

Occupational therapy-based and evidence-supported recommendations for assessment and exercises in hand osteoarthritis

“…(7) Exercise programmes should include an exercise aimed at strengthening the muscles stabilising the CMC joint and extending the thumb (96%) (10, 6-10). Exercises to strengthen the structure around the CMC joint to maintain stability are recommended and/or used in six studies (16,17,38,39,44,46), and are also frequently used by hand therapists in the UK (15). Also, it has been shown in three studies that thumb osteoarthritis is associated with more pain and activity limitations (31,33,37).…”

Evaluation of Physical Examination Tests for Thumb Basal Joint Osteoarthritis

“…The grind test is perhaps the most commonly referenced diagnostic tool to evaluate and confirm osteoarthritis. [2][3][4]6,14,15,17 To perform the grind test, the examiner applies axial compression along the plane of the thumb metacarpal and simultaneously rotates the thumb metacarpal base (Figure 1). The test is positive if it reproduces pain in the joint.…”