التهاب المفاصل
What is it:
Arthritis is a condition that brings to a degeneration and gradual destruction of the joints. At the level of the hand the more frequently involved joints are the ones of the fingers and the one at the base of the thumb. Usually it affects all the population but mainly female starting from the fourth decade. Two different type of arthritis can be identified: primary, without an identified aetiology and secondary; in this latter case the cause is related to trauma, such as fracture, or to particular activities of the hand. Clinically it presents mainly in the morning. Patients refer to have difficulty, right after waking up, in moving the hand with a stiffness sensation.
How to treat it:
Unfortunately no treatment able to cure or stop this degeneration has been found yet. At early stages is mandatory to try a conservative treatment. For this purpose custom made splints by an hand therapist, associated with a non steroid anti-inflammatory therapy, can be effective. In selected cases steroid injection could give some results in relieving symptoms.
Surgery must be always the last option and it should be used in case of important pain or in case of severe functional impairment.
Many surgical procedure have been advocated; among them the artrhodesis (fusing the involved joints), arthroplasties and prostheses positioning. Nowadays new generation pyrocarbone implants are available for the metacarpalphalangeal joint (MCP), interphalangeal joints (PIP), for the hand bones (STPI and RCP), for the joint at the base of the thumb (PI2, PYRODISC and CMC) as well as for degenerative or post traumatic condition of the wrist (APSI and DRUJ).