II. Epidemiology
- Hand less commonly affected in Osteoarthritis
- Hand Osteoarthritis is most common in postmenopausal women (esp. age over 70 years)
- Hand most disabling of joints to be involved
III. Signs
- Trapeziometacarpal joint (first carpometacarpal joint at base of thumb, Thumb Base Osteoarthritis)
- Most common site for Hand Osteoarthritis
- Pain, swelling, weakness and decreased thumb base range of motion
- Provoked by repeated gripping, pinching and forceful thumb use
- Treated with NSAIDs (oral, topical), occupational therapy, Thumb Spica Splint
- First Carpometacarpal Joint Steroid Injection in refractory or severe cases
- Heberden's Nodes
- Distal interphalangeal joint (ITP) nodular swelling
- Bouchard's Nodes
- Proximal interphalangeal joint (PIP) nodular swelling
- Mucous cysts may develop at interphalangeal joints
-
First Metacarpal-phalangeal joint (MCP) involvement
- Other MCP joints are generally spared
-
Wrist spared
- Contrast with Rheumatoid Arthritis
IV. Diagnosis: Hand Osteoarthritis Diagnostic Criteria (American College Rheumatology)
- Hand pain, aching or stiffness and
- Two DIP or PIP joints with hard tissue enlargement and
- Less than 3 swollen MCP joints
- One of the following
- Two DIP joints with hard tissue enlargement or
- Deformity of two DIP, PIP, or MCP joints
- References
V. Imaging
- See Hand XRay in Osteoarthritis
- May demonstrate Osteoarthritis severity (osteophytes, joint space narrowing)
VI. Management
- See Osteoarthritis
-
NSAIDs
- Oral NSAIDs (caution in older patients, renal disease, Peptic Ulcer Disease)
- Topical NSAID (e.g. Diclofenac Gel)
- Intermittent Splinting
- Thumb Spica Splint for Thumb Osteoarthritis
- Moist heat
- Occupational therapy
- Local Corticosteroid Injection
- Contrast Baths
- Surgery for resistant cases
- Arthroplasty
- Arthrodesis
VII. References
Images: Related links to external sites (from Bing)
Related Studies
| Concepts | Finding (T033) |
| SnomedCT | 371598009, 86376005, 201821005 |
| English | Heberden's nodes, HEBERDEN NODES, Heberden's nodes (physical finding), painless nodule on distal interphalangeal (DIP) joint, Heberden's nodes (painless nodules DIP), Heberden's nodes were seen, Heberden node, heberden nodes, Heberdens nodes, heberden's node, heberden node, heberden's nodes, heberdens node, Heberden's node (disorder), Heberdens' nodes, Heberden's node, Heberden's node (finding), Heberden; node, node; Heberden, Heberden's Node, Tuberculum Arthriticum, heberdens nodes |
| Dutch | Heberden-knobbels, Heberden; nodus, nodus; Heberden |
| French | Nodosités d'Heberden |
| German | Heberden-Knoten |
| Italian | Noduli di Heberden |
| Portuguese | Nódulos de Heberden |
| Spanish | Nódulos de Heberden, nódulo de Heberden (trastorno), nódulo de Heberden (hallazgo), nódulo de Heberden |
| Japanese | ヘバーデン結節, ﾍﾊﾞｰﾃﾞﾝｹｯｾﾂ |
| Czech | Heberdenovy uzly |
| Hungarian | Heberden-csomók |
Ontology: Osteoarthritis of the hand (C0263746)
| Concepts | Disease or Syndrome (T047) |
| SnomedCT | 22193007, 287011007, 267896009, 201891001, 156491002 |
| English | Osteoarthritis NOS, of the hand, Osteoarthritis NOS-hand, Osteoarthritis of the hand, osteoarthrosis of hand, osteoarthritis of hand, osteoarthritis of hand (diagnosis), osteoarthrosis of hand (diagnosis), Osteoarthrosis of hand, hands osteoarthritis, hand osteoarthritis, osteoarthritis hand, Osteoarthritis - hand joint (disorder), Osteoarthritis NOS, of the hand (disorder), Degenerative joint disease of hand, Osteoarthritis - hand joint, Degenerative joint disease of hand (disorder), Hand osteoarthritis |
| Dutch | osteoartritis hand |
| French | Ostéoarthrite des mains |
| German | Osteoarthritis der Hand |
| Italian | Osteoartrite della mano |
| Portuguese | Osteartrite da mão |
| Spanish | Artrosis de mano, artrosis de mano, enfermedad articular degenerativa de mano, osteoartrosis de articulación de mano, enfermedad articular degenerativa de mano (trastorno), artrosis de la mano, artrosis de la mano (trastorno), osteoartritis - articulación de la mano, artrosis - articulación de la mano, artrosis - articulación de la mano (trastorno), artrosis, SAI, de la mano (trastorno), artrosis, SAI, de la mano, osteoartritis - articulación de la mano (trastorno) |
| Czech | Osteoartritida ruky |
| Japanese | 変形性手関節症, ﾍﾝｹｲｾｲﾃｶﾝｾﾂｼｮｳ, ﾍﾝｹｲｾｲｼｭｶﾝｾﾂｼｮｳ |
| Hungarian | Kéz arthrosis |
Ontology: Bouchard's node (C0263780)
| Concepts | Disease or Syndrome (T047) |
| SnomedCT | 20243008, 201821005 |
| English | Bouchard's nodes, painless nodules on PIP, Bouchard's nodes (physical finding), painless nodules on proximal interphalangeal joint (PIP), Bouchard's nodes were seen, Bouchard node, bouchard's node, bouchard's nodes, Bouchards' nodes, Bouchard's node, Bouchard's node (disorder), Bouchard; node, node; Bouchard |
| Dutch | Bouchard-noduli, Bouchard; nodus, nodus; Bouchard |
| French | Noeuds de Bouchard |
| German | Bouchard-Arthrose |
| Italian | Noduli di Bouchard |
| Portuguese | Nódulos de Bouchard |
| Spanish | Nódulos de Bouchard, nódulos de Bouchard, nódulos de Bouchard (trastorno), nódulo de Bouchard (trastorno), nódulo de Bouchard |
| Japanese | ブシャール結節, ﾌﾞｼｬｰﾙｹｯｾﾂ |
| Czech | Bouchardovy uzly |
| Hungarian | Bouchard-csomók |
Ontology: Osteoarthrosis of the carpometacarpal joint of the thumb (C0409956)
| Concepts | Disease or Syndrome (T047) |
| ICD10 | M18 , M18.9 |
| SnomedCT | 37895003 |
| English | OA of first carpometacar joint, Osteoarthritis of first carpometacarpal joint, unspecified, Osteoarthritis basilar joint of thumb, osteoarthritis of first carpometacarpal joint (diagnosis), osteoarthritis of first carpometacarpal joint, osteoarthritis hand carpometacarpal joint first, Osteoarthrosis of the carpometacarpal joint of the thumb, Osteoarthritis of first carpometacarpal joint, Osteoarthrosis of the carpometacarpal joint of the thumb (disorder) |
| Spanish | osteoartrosis de la articulación carpometacarpiana del dedo pulgar (trastorno), artrosis de articulación carpometacarpiana de dedo pulgar, artrosis de articulación carpometacarpiana de dedo pulgar (trastorno), osteoartrosis de articulación carpometacarpiana de dedo pulgar (trastorno), osteoartrosis de la articulación carpometacarpiana del dedo pulgar, osteoartrosis de articulación carpometacarpiana de dedo pulgar |
