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Osteoarthritis of the Hand ˌäs-tē-ō-är-ˈthrīt-əs

By David R. Steinberg, MD, Associate Professor, Department of Orthopaedic Surgery, and Director, Hand and Upper Extremity Fellowship, Perelman School of Medicine at the University of Pennsylvania

Osteoarthritis of the hand causes swelling, pain, and sometimes formation of cysts on the finger joints (particularly the outermost ones).

Osteoarthritis of the hand is apparent by overgrowth of bones over the outermost joints of the fingers (Heberden nodes) and the middle joints of the fingers (Bouchard nodules). These joints and the base of the thumb become stiff and sometimes painful. The wrists and the joints between the fingers and hand are usually not affected. The involved joints can become misaligned.


Doctors usually can base the diagnosis on an examination. The deformity can also be seen on x-rays. Unlike in rheumatoid arthritis, results of blood tests that indicate inflammation (such as the erythrocyte sedimentation rate [ESR] and the numbers of white blood cells) are usually normal, regardless of how severe the disorder is.


Treatment may include range-of-motion exercises in warm water to relieve pain during the exercises and to keep the joints as flexible as possible, rest, splinting intermittently to prevent deformity, and use of analgesics or nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve pain and swelling. Occasionally, a corticosteroid suspension may need to be injected into severely affected joints to relieve pain and increase range of motion. Rarely, when osteoarthritis is advanced and other treatments are not effective, the joint may need to be reconstructed or fused surgically. The hand joint that most often requires surgery for osteoarthritis is the base of the thumb.