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Hand involvement is extremely common in osteoarthritis.
Osteoarthritis affecting the hand may be asymptomatic enlargement of nodules at the proximal interphalangeal joint (Bouchard's nodules) or distal interphalangeal joint (Heberden's nodes) or angulation at these joints. Pain and stiffness of these joints and the base of the thumb are also common. The wrist usually is spared, and there is usually minimal or no metacarpophalangeal joint involvement unless the patient also has a metabolic disorder (eg, hemochromatosis). Differentiation of hand changes in osteoarthritis from those in RA is discussed in Symptoms of Joint Disorders: Differential Features of the Hand in RA and Osteoarthritis .
Treatment
Treatment is symptomatic with analgesics, appropriate rest, splinting, and occasionally corticosteroid injection as needed. Surgical procedures can help relieve pain and correct deformity for severe changes at the base of the thumb and, less commonly, for advanced degeneration of the interphalangeal joints.
Last full review/revision March 2008 by David R. Steinberg, MD
Content last modified March 2008
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