Osteoarthritis of the hand
- Incidence: 6000.00 cases per 100,000 person-years
- Peak incidence: 70+ years
- Sex ratio: more common in females 2:1
|Osteoarthritis of the hand||1|
- Genetics: Genes that encode for ‘collagen type II’ are thought to be involved especially in interphalangeal involvement. There is ongoing research into this.
- Previous trauma of a joint increases the risk of having OA in that joint
- Hypermobility of a joint increases the risk of OA in that joint
- Occupation e.g. cotton workers and farmers are more susceptible to hand OA
- Osteoporosis reduces the risk of OA
- Usually bilateral: Usually one joint at a time is affected over a period of several years. The carpometacarpal joints (CMCs), distal interphalangeal joints (DIPJs) are affected more than the proximal interphalangeal joints (PIPJs).
- Episodic joint pain: An intermittent ache. Provoked by movement and relieved by resting the joint.
- Stiffness: Worse after long periods of inactivity e.g. waking up in the morning. Stiffness lasts only a few minutes compared to the morning joint stiffness seen in rheumatoid arthritis.
- Painless nodes (bony swellings): Heberden’s nodes at the DIPJs, Bouchard’s Nodes at the PIPJs. These nodes are the result of osteophyte formation.
- Squaring of the hand: Deformity of the carpometacarpal joint of the thumb resulting in fixed adduction of the thumb.
- Functionally patients do not usually have any problems. If there is severe involvement of the DIPJs, there may be reduced grip strength which can result in disuse atrophy.
- X-ray: radiologically there are osteophytes and joint space narrowing. Often signs may be visible on X-ray, before symptoms develop