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Osteoarthritis of the Hand
Aka: Osteoarthritis of the Hand, Hand Osteoarthritis, Heberden's Node, DIP Bony Joint Enlargement, Bouchard's Node, PIP Bony Joint Enlargement
- See Also
- Osteoarthritis
- Knee Osteoarthritis
- Epidemiology
- Hand less commonly affected in Osteoarthritis
- Hand most disabling of joints to be involved
- Signs
- Most common site
- Trapeziometacarpal joint (base of thumb)
- 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
- 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
- Altman (1990) Arthritis Rheum 33:1601-10 [PubMed]
- Radiology
- See Hand XRay in Osteoarthritis
- Management
- NSAIDs
- Intermittent Splinting
- Moist heat
- Local Corticosteroid Injection
- Contrast Baths
- Surgery for resistant cases
- Arthroplasty
- Arthrodesis