Finger and Thumb Joint Osteoarthritis: Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps:

  • General physical examination – including blood pressure, pulse, body weight, height; further:
    • Inspection (viewing).
      • Skin (normal: intact; abrasions/wounds, redness, hematomas (bruises), scars) and mucous membranes.
      • Body or joint posture (upright, bent, gentle posture).
      • Malpositions (deformities, contractures, shortenings).
      • Muscle atrophies (side comparison!, if necessary circumference measurements).
      • Joint (abrasions/wounds, swelling (tumor), redness (rubor), hyperthermia (calor); injury evidence such as hematoma formation (bruise), arthritic joint lumpiness, leg axis assessment) [spindle-shaped swelling around joint?, Mucoid cysts at the finger end joint?, redness of the joint?; at dorsoradial metacarpal base pronounced adduction contracture (functional and movement restriction) of the first metacarpal bone (= advanced stage of rhizarthrosis)?]
    • Palpation (palpation) of prominent bone points, tendons, ligaments; musculature; joint (joint effusion); soft tissue swelling; pressure pain (localization!).
    • Measurement of joint mobility and range of motion of the joint (according to the neutral zero method: the range of motion is given as the maximum deflection of the joint from the neutral position in angular degrees, where the neutral position is designated as 0°. The starting position is the “neutral position”: the person stands upright with the arms hanging down and relaxed, the thumbs pointing forward and the feet parallel. The adjacent angles are defined as the zero position. Standard is that the value away from the body is given first). Comparative measurements with the contralateral joint (side comparison) can reveal even small lateral differences.
    • If necessary, special functional tests
      • Grinding test – to check for the presence of osteoarthritis in the carpometacarpal joint (thumb saddle joint): pressure is applied to the joint. The thumb is rotated slightly inwards and outwards. If noises like grinding / grating (“Grinding”) occur during these movements, this is an indication of degenerative changes.
    • Assessment of blood flow, motor function and sensitivity:
      • Circulation (palpation of pulses).
      • Motor function: testing of gross strength in a lateral comparison.
      • Sensibility (neurological examination)
  • Health check

Square brackets [ ] indicate possible pathological (pathological) physical findings.