Isolated osteoarthritis (OA) of the trapezioscaphoid (TS) joint is little recognized. Nine cases that were examined clinically and radiologically are described. Of these 4 had isolated TS OA, 3 also had generalized OA, and 2 also had rheumatoid arthritis. Symptoms and signs, including pain in the wrist and thumb base, radial and volar swelling, and tenderness over the scaphoid, allowed distinction from other causes of pain at the thumb base. A wrist-working splint was beneficial in relieving pain.Degenerative arthritis (OA) of the trapezio scaphoid (TS) joint as a symptomatic isolated carpal lesion has been largely unrecognized. In contradistinction, degenerative arthritis of the first carpometacarpal (CM) joint is a well-recognized condition (1) that may present as an isolated lesion on one or both sides (2) or may be one of many joints affected in primary generalized OA, with or without Heberden's and/or Bouchards nodes (3). Carstam et a1 (4) describe T S OA in 15 of a series of 48 patients presenting with volar wrist swelling. Twelve had TS OA only and 3 also had first carpometacarpal joint OA. In several patients the volar wrist swelling was thought to be a ganglion, but arthrographic studies revealed a communication between the T S joint and the peritendinous space of the flexor carpi radialis tendon, suggesting that the observed swelling was in fact synovial in origin. Sims and Bentley (5) state that a considerable proportion of patients with first CM OA also had arthritis in the T S joint and occasionally in the remaining joints of the carpus, and Sharp (6) notes that if T S OA coexists with first CM OA the symptoms of the former are obscured by those of the latter, but he does not mention isolated T S OA. This paper presents 9 cases in which the presence of OA in the T S joint on one or both sides was radiologically observed. The patients were assessed clinically by the author, and all had standard wrist and hand radiographs taken. X-ray (Figure 1) showed narrowing a n d sclerosis of Submitted for publication August 29, 1974; accepted the right TS joint and a n osteophyte on the lateral aspect December 4, 1975. of the trapezium. snuff box.
CASE REPORTS