Carpal Metacarpal Arthritis

What is carpal metacarpal arthritis?

carpal-metacarpal-arthritisCarpal metacarpal arthritis is arthritis at the base of the thumb joint. In a normal joint, cartilage covers the ends of each bone providing smooth and easy movement between the two surfaces. The cartilage can wear out due to daily use and occurs throughout life. It can also be injured by traumatic events. When the cartilage is worn out and both ends of the bones rub against each other, it is called osteoarthritis. A common place for osteoarthritis to develop in the hand is the joint at the base of the thumb. This joint is formed by two bones called the trapezium and the first metacarpal. The joint provides a wide range of movement for the thumb.

What are the signs and symptoms of carpal metacarpal arthritis?

Symptoms of carpal metacarpal arthritis include pain at the base of the thumb while performing grasping or pinching motions. Generally, pain can be elicited while opening jars, turning a doorknob, or turning a key. Grip and pinch strength diminishes as the condition worsens and in severe cases, the base of the thumb can be deformed due to partial dislocation of the joint (joint out of place). Osteoarthritis involving the thumb is more frequent in women than in men. It is generally seen after the age of 40. Either hand can be affected.

How is it diagnosed?

The diagnosis of carpal metacarpal arthritis is made by the clinical examination of pain and swelling. Grinding can be felt as a result of the arthritic surfaces rubbing against each other as thumb motion is evaluated. X-rays show classic signs of arthritis, which include a narrow joint space, bone spur formation around the joint and dislocation if the condition is longstanding.

What is the treatment for carpal metacarpal arthritis?

Treatment for this condition consists of thumb immobilization with a splint and oral anti-inflammatory medications to diminish swelling and pain. Also, injections with local anesthetic and a steroid may be used. Patients with constant pain and no improvement with these conservative measures may require surgery. Several techniques have been developed for this condition. Your hand surgeon can advise you as to which is the best option.


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