Osteoarthritis of the hand
Osteoarthritis is a degenerative joint disease in which the cushioning cartilage that covers the bone surfaces at the joints begins to wear out. It may be caused by simple “wear and tear” on joints, or it may develop after an injury to a joint. In the hand, osteoarthritis most often develops in three sites (see Figure 1):
at the base of the thumb, where the thumb and wrist come together (the trapezio-metacarpal, or basilar, joint)
at the end joint closest to the finger tip (the distal interphalangeal or DIP joint)
at the middle joint of a finger (the proximal interphalangeal or PIP joint)
It also often develops in the wrist.
Signs and symptoms of arthritis of the hand
Stiffness, swelling, and pain are symptoms common to all forms of arthritis in the hand. With osteoarthritis, bony nodules may develop at the middle, or PIP, joint of the finger (Bouchard’s nodes), and at the end-joints, or DIP, of the finger (Heberden’s nodes) (see Figure 2). A deep, aching pain at the base of the thumb is typical of osteoarthritis of the basilar joint. Swelling and a bump at the base of the thumb where it joins the wrist may also be observed. Grip and pinch strength may be diminished, causing difficulty with activities such as opening jars or turning keys. Pain, swelling, stiffness, and diminished strength are also seen with osteoarthritis of the wrist.