OA of Hand and Wrist

Question 1

define OA

Answer 1

wear and tear of small joints

Question 2

who is DIP joint OA very common in?

Answer 2

postmenopausal women

Question 3

presentation

Answer 3

painful, swollen and tender, eventually affecting all fingers
stiffness
bony thickening in DIP (Heberden’s nodes)
dorsal ganglion cyst (mucous cyst)
PIP bony swelling (Bouchard’s nodes- also seen in RA)
MCP rarely affected unless previous injury, occupational stress, gout or infection

Question 4

management for mild

Answer 4

removal of osteophytes and excision of mucous cyst

Question 5

management for severe

Answer 5

arthrodesis

Question 6

management of index finger

Answer 6

arthrodesis may be required to preserve pincer grip, for other fingers replacement arthroplasty may be required but results are variable

Question 7

management for MCP

Answer 7

joint replacement
injection steroids for flare up of pain
exicsion arthroplasty (trapeziectomy)
fusion for chronic pain

Question 8

complications of surgical management

Answer 8

ulnar drift

extensor tendon subluxation

Question 9

why does OA of the radio-carpal joint of the wrist occur?

Answer 9

consequence of trauma

Question 10

management of OA of radio-carpal joint?

Answer 10

wrist arthroplasty

fusion