Osteoarthritis of the thumb trapeziometacarpal joint

The Effectiveness of a Manual Therapy and Exercise Protocol in Patients With Thumb Carpometacarpal Osteoarthritis: A Randomized Controlled Trial

“…2,15,42,44 Patients with CMC joint OA represent the cohort of individuals with upper extremity arthritis most likely to undergo surgical intervention. 3 However, previous studies examining the effectiveness of surgical intervention have reported varied levels of benefits in terms of pain reduction and improved function, and have demonstrated an adverse event rate of between 10% and 22%, depend-T T STUDY DESIGN: Double-blind, randomized controlled trial.…”

Carpometacarpal osteoarthritis of the thumb

“…2 The carpometacarpal joint of the thumb is the most common site in the hand for which surgery is sought. 1 Although most patients report a high degree of relief postoperatively, thumb strength is expected to decrease from preoperative values. 5 Function is restored primarily through pain-free use of the thumb.…”

“…The presentation of this condition can mimic that of a ganglion, ruptured tendon, carpal fracture, carpal instability, De Quervain's tenosynovitis, trigger thumb, a torn ulnar collateral ligament and tendinitis of the flexor carpi radialis. 1,2 Findings that suggest an alternative diagnosis include deformity of the back of the wrist, limited or painful movement of the wrist, swelling or hematoma, a positive result on the Finklestein test, locking during flexion, ligamentous laxity and lack of palpable flexor or extensor tendons when assessing range of motion.…”

“…1 Findings consistent with osteoarthritis include narrowing of the joint space and osteophytes, in addition to subchondral sclerosis and cysts, which can be used to stage disease using the Eaton and Littler classification. 2 In late-stage disease, radiographs show degenerative changes in the scaphotrapezial joint and a "zigzag" deformity (Appendix 1, available at www .cmaj .ca /lookup /suppl /doi:10.1503/cmaj.111444/-/DC1).…”

“…It is the second most common site of degenerative disease in the hand after arthritis of the distal interphalangeal joints. 1 Risk factors for carpometacarpal osteoarthritis of the thumb include being female, middle age, previous trauma, repetitive use and inflammatory joint disease. 1 Lifetime prevalence of this condition approaches 10%.…”