Osteoarthritis of the Hand & Wrist

Osteoarthritis is also known as degenerative joint disease or DJD. It is a progressive degeneration of the joint cartilage. Although it primarily affects weight-bearing joints, such as the hips and knees, hands are often affected. Almost 33% of adults have some evidence of joint degeneration on x-ray examination. By the age of 60, the percentage increases to approximately 70%. Of those adults who have arthritic changes visible on x-ray, only about half say they experience significant symptoms.

Osteoarthritis may occur as a result of another disorder, such as an infection, fracture, or previous trauma. Or the cause may not be known. When the cause of osteoarthritis is unknown, it is described as primary osteoarthritis. What occurs is a gradual process resulting in damage to joint cartilage.

Cartilage is normally a smooth, white, translucent substance with nearly the same strength as bone. With osteoarthritis, the texture and strength of cartilage tissue changes to a rough, yellow, opaque, soft, and thin substance. The cartilage serves as a cushion between bony surfaces, so when it thins, the bony surfaces move closer together and begin to rub against each other. Some of the cartilage may tear away from the bone and fluid accumulates, causing swelling and further impairment of joint mobility. A progressive disease, the inflammation of arthritis continues and damage to the bony structures and cartilage increases. New bony outgrowths are formed causing joint deformities.

Several predisposing factors are known to accelerate the degenerative changes of osteoarthritis. In the hands, excessive use, for example by an artist or seamstress, can contribute to the development of osteoarthritis. Other predisposing factors include diabetes mellitus, hemophilia, or bone structure defects. Osteoarthritis appears to have a genetic influence as well.

The symptoms of osteoarthritis are primarily confined to the affected joints. This differentiates osteoarthritis from rheumatoid arthritis, which is a systemic disease, meaning it affects the entire body.

In osteoarthritis, the joints feel stiff and painful, and the affected joints are swollen. You may notice a grating sensation when the bones in the hand and wrist rub against each other. The left and right hands may be affected to different degrees. Occasionally, nodules, or new bony growths occur in the fingers. Heberden’s nodes may be seen at the ends of the fingers or Bouchard’s nodes may grow at the base of the fingers near the palm of the hand. As the disease progresses, the hand and fingers become more uncomfortable, less functional, joints may lose their normal alignment, and severe deformities may result.

Treatment of arthritis has improved dramatically over the past decade, with new medications as well as improved surgical techniques helping people find effective options.

For more information about osteoarthritis of the hand and wrist, please call (918) 494-AOOK (2665).