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carpometacarpal arthritis; carpometacarpal osteoarthritis
Epidemiology:
- common, frequently work-related
- older adults, elderly
Clinical manifestations:
- pains at the palmar base of the thumb that occurs with gripping & pinching
- pain may radiate to distal forearm
- tenderness to palpation on both the dorsal & palmar surfaces of the carpometacarpal joint
- compressing the joint by appling longitudinal pressure may reproduce the pain
- rotating the thumb while applying axia pressure may reproduce pain
- joint stiffness
- loss of range of motion
- negative Finkelstein test
Management:
- carpometacarpal osteoarthritis not responsive to NSAIDs*
- carpometacarpal orthosis/splinting & occupational therapy [2,3]
* or NSAIDs contraindicated (chronic renal failure)
Related
carpometacarpal joint
General
osteoarthritis of the hand
References
- Medical Knowledge Self Assessment Program (MKSAP) 16,
American College of Physicians, Philadelphia 2012
- NEJM Knowledge+ Rheumatology
- Esteban Lopez LMJ et al.
Long-term outcomes of nonsurgical treatment of thumb carpometacarpal osteoarthritis:
A cohort study.
J Bone Joint Surg Am 2023 Dec 6; 105:1837.
PMID: 37903291 PMCID: PMC10695337 Free PMC article
https://journals.lww.com/jbjsjournal/fulltext/2023/12060/long_term_outcomes_of_nonsurgical_treatment_of.2.aspx