Hand osteoarthritis

General information

Hand osteoarthritis is a pathological condition characterized by the defeat of the fingers’ joints. Degenerative-dystrophic processes occur in these joints, accompanied by cartilage tissue destruction and hand joint deformation. If you do not take measures to treat osteoarthritis of the hands at the initial stages, irreversible changes will occur in the joints, leading to a permanent function violation.

During the disease process, not only the bone tissue but also the capsule and nearby muscles will be affected.

Etiology

Identifying the cause of osteoarthritis of the interphalangeal joints of the hands is not always possible. Such pathology is called primary. In addition, there is secondary osteoarthritis, which occurs due to the following factors:

• surgical intervention;
• from the trauma he suffered;
• endocrine disorders;
• blood disorders in the hands.

Clinical manifestations

In most cases, osteoarthritis of the fingers affects the joints between the penultimate and last phalanges, but it can also affect other joints.

The symptomatology of the disease involves the appearance of thickening on the joints of the fingers, which are not characterized by pain and are visible from the back of the hand. Attempts to bend/extend these joints are accompanied by crunching. In addition, the patient notes the following symptoms:

• feeling of morning stiffness in the fingers;
• increased pain sensations as the disease progresses;
• swelling of the affected joints, redness of the skin over them;
• painful cysts between the affected joint and the nail.

As the disease progresses, it affects more joints and leads to finger curvature. Fine motor skills are affected, and the further the disease progresses, the more difficult it is for the patient to maintain himself.

It is assumed that the first symptoms of osteoarthritis (deforming arthrosis) of the hands appear between the ages of 40 and 60, but they can now be observed in younger people.

Notably, 80% of patients whose radiologic images show degenerative changes in the joints may not experience a clinical manifestation of pathology. At first, symptoms appear only during movement of the hand; later, they can be observed at rest and even at night. Osteoarthritis of the hands is characterized by the following symptoms (they require mandatory consultation with a specialized doctor and appropriate treatment):

• Pain. A typical painful sensation occurs when moving the hand and disappears at rest; it increases at the end of the day and night. The problem occurs at the beginning of movement, for example, when a person tries to lift a heavy object. As a rule, pain is felt only in the affected joint and does not irradiate to nearby areas. Thus, in the case of arthrosis of the hip joint, the pain can be felt in the lower back or groin.
• Stiffness. It often occurs in the morning after waking up and usually passes within 5-10 minutes. It is difficult for the patient to make hand movements; there is stiffness in the joint.
• Limitation of motor ability. The affected joints gradually lose their full range of motion, making it difficult for the patient to make circular turns with the hand. Gradually involve the small joints of the fingers. Deterioration of the function of the affected joint can lead to atrophy of the surrounding muscles and disability.
• Crunching. It is felt when moving the joint. The symptom occurs due to synovial fluid deficiency, accompanied by friction of joint surfaces, hence the development of crunch and creaking in the joint.
• Bone tissue damage. This radiological symptom results from a change in the axis of the joint position, which is also accompanied by the formation of bone growths—osteophytes.

Classification

Deforming osteoarthritis is often accompanied by several symptomatic periods:

• Stabilization period. Clinical manifestations of hand osteoarthritis are constant but occur only when moving the hands.
• Periods of exacerbation. Symptomatology progresses with increasing joint pain and stiffness. Signs of the disease occur at rest and can worsen at night. Often, the joints swell due to the accumulation of exudative fluid, which occurs as a result of inflammation in response to further damage to the cartilage.

Causes of the disease

There are a number of factors that cause the destruction of joint cartilage and lead to degenerative diseases. Some we can influence, others we cannot. We are talking about genetics, the poor chemical composition of synovial fluid, insufficient blood supply to the joints, and the influence of various diseases, including diabetes and hormonal disorders, especially hypothyroidism. Also, we are not influenced by age and gender. It is known that the probability of osteoarthritis increases with age and is higher in women who have entered the menopause stage.

The leading causes that influence the development of osteoarthritis of the hands include the following:

• Older age. The risk of degenerative changes in the joints increases with age, although there are elderly people who have no signs of this pathology. It should be remembered that osteoarthritis is not only a “natural symptom of aging” but also a consequence of many other factors that must be identified before treatment.
• Hormonal changes. Osteoarthritis of the hand joints often develops in women during rapid hormonal changes. This usually happens during menopause, when the body’s calcium and vitamin D levels actively decrease. It is important to adhere to a balanced diet and use food and vitaminized supplements to compensate for the lack of useful substances.
• Occupational activities. It has been found that arthrosis of the hands is often exposed to people whose work is associated with an increased load on the hands. Working at a computer or a loom leads to joint microtrauma and hurts cartilage tissue conditions.
• Associated disorders. Patients with osteoarthritis have been found to have metabolic disorders in the body, such as problems with digestion or being overweight.

Diagnosis

Before developing an individualized treatment plan, doctors perform a comprehensive diagnostic evaluation, which includes:

• an examination by an orthopedic surgeon, history taking;
• radiographs;
• MRI and CT;
• Ultrasound of the affected joints;

Treatment

Conservative and surgical methods carry out treatment of this disease, but the latter are resorted to only in the most extreme cases:

• when the disease is in its advanced stages;
• when conservative treatment fails to produce the desired results.

Trauma doctors direct all their efforts to alleviate the patient’s suffering and, therefore resort to measures that allow:

• minimize inflammation;
• to eliminate the pain;
• to slow down deformation processes;
• to prevent disabilities;
• improve the quality of life.

Conservative treatment involves:

• taking medication;
• physical therapy;
• physical therapy;

Suppose all means of conservative therapy did not bring the desired result. In that case, doctors recommend surgical interventions, such as prosthetics of small joints of the wrist or arthrodesis of the joints of the hand.

All these treatment options are available in more than 980 hospitals worldwide (https://doctor.global/results/diseases/hand-osteoarthritis). For example, Interphalangeal joint arthrodesis can be performed in these countries at following approximate prices:

Turkey $4.0 K in 32 clinics

Germany $12.4 K in 40 clinics

Israel $16.2 K in 16 clinics

United States $16.4 K in 19 clinics

China $16.9 K in 6 clinics.