Thumb Saddle Joint Arthrosis

Thumb Saddle Joint Arthrosis (Rhizarthrosis): Complications

The following are the most important diseases or complications that can be caused by rhizarthrosis (thumb saddle joint osteoarthritis): Musculoskeletal system and connective tissue (M00-M99). Arthritis (inflammation of the joints) Movement restriction Loss of function of the hand Joint malpositions Contractures – permanent shortening of the muscles with resulting joint constraint. Synovialitis chondrodetritica (inflammation of … Thumb Saddle Joint Arthrosis (Rhizarthrosis): Complications

Thumb Saddle Joint Arthrosis (Rhizarthrosis): Classification

Classification of rhizarthrosis according to Eaton/Little. Stage Native radiological pathologies 1 Joint splitter extension if necessary 2 Joint space narrowing, osteophytes (bone neoplasms), free joint bodies <2 mm. 3 Progressive joint narrowing, osteophytes, free joint bodies > 2 mm. 4 Additional osteoarthritis of the scaphoid (scaphoid trapezoid) joint (STT joint; joint between the scaphoid (scaphoid … Thumb Saddle Joint Arthrosis (Rhizarthrosis): Classification

Thumb Saddle Joint Arthrosis (Rhizarthrosis): Cartilage-Protective Agents (Chondroprotectants)

Chondroprotectants inhibit cartilage-degrading substances and thus reduce further loss of protective cartilage. At the same time, they promote the regeneration of cartilage tissue.Furthermore, they are believed to have an anti-inflammatory effect. As a result, there is a reduction in pain, swelling and improved joint mobility. The greatest success is achieved by injecting chondroprotectants directly into … Thumb Saddle Joint Arthrosis (Rhizarthrosis): Cartilage-Protective Agents (Chondroprotectants)

Thumb Saddle Joint Arthrosis (Rhizarthrosis): Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; furthermore: 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 … Thumb Saddle Joint Arthrosis (Rhizarthrosis): Examination

Thumb Saddle Joint Arthrosis (Rhizarthrosis): Test and Diagnosis

Laboratory parameters of the 1st order – obligatory laboratory tests. Small blood count Inflammatory parameters – CRP (C-reactive protein) or ESR (erythrocyte sedimentation rate). Uric acid Laboratory parameters 2nd order – depending on the results of the history, physical examination, etc. – for differential diagnostic clarification. Examination of the joint punctate Rheumatoid factor (RF) ANA … Thumb Saddle Joint Arthrosis (Rhizarthrosis): Test and Diagnosis

Thumb Saddle Joint Arthrosis (Rhizarthrosis): Drug Therapy

Therapeutic target Pain relief and thus improvement of mobility. Therapy recommendations Depending on the severity of the disease and individual problems, the following medications can be used: Analgesics (painkillers) Non-acid analgesics Nonsteroidal anti-inflammatory drugs (NSAIDs; non steroidal anti- inflammatory drugs, NSAIDs). Selective COX-2 inhibitors (coxibe). Opioid analgesics Glucocorticoids as ointments, intraarticular/into the joint, systemically if … Thumb Saddle Joint Arthrosis (Rhizarthrosis): Drug Therapy

Thumb Saddle Joint Arthrosis (Rhizarthrosis): Diagnostic Tests

Obligatory medical device diagnostics. Radiographs of the affected joint Evidence of migration of the thumb out of the saddle joint may be evident (instability of the joint) Joint space narrowing Subchondral (lying below the cartilage) cysts. Note: The severity of radiographic findings need not correlate with clinical symptoms. Optional medical device diagnostics – depending on … Thumb Saddle Joint Arthrosis (Rhizarthrosis): Diagnostic Tests

Thumb Saddle Joint Arthrosis (Rhizarthrosis): Surgical Therapy

If conservative measures do not lead to the desired success, the following surgical measures can be considered for rhizarthrosis (carthrosis of the thumb saddle joint): Resecting arthroplasty (gold standard); in long-term studies, very good to good results have been achieved in 80-95%; the procedure: Resection (removal) of the arthritically altered os trapezium (carpal bone/large polygonal … Thumb Saddle Joint Arthrosis (Rhizarthrosis): Surgical Therapy

Thumb Saddle Joint Arthrosis (Rhizarthrosis): Phytotherapeutics

Herbal antirheumatic drugs Herbal preparations can be used for supportive, analgesic (pain-relieving) therapy. Application is mainly: Nettle herb – analgesic and antirheumatic effects; dosage: 50-100 g of nettle porridge per day. Gamma-linolenic acid (GLA) – e.g. borage oil, evening primrose oil; gamma-linolenic acid is an omega-6 fatty acid that has anti-inflammatory (anti-inflammatory) effects via prostaglandin … Thumb Saddle Joint Arthrosis (Rhizarthrosis): Phytotherapeutics

Thumb Saddle Joint Arthrosis (Rhizarthrosis): Prevention

To prevent rhizarthrosis (thumb saddle joint osteoarthritis), attention must be paid to reducing individual risk factors. Behavioral risk factors Physical activity Underloading of the cartilage: Lack of physical activity – since cartilage gets its micronutrients from the synovial fluid, it relies on the joint being moved for cartilage growth Nutritive damage (eg, long rest in … Thumb Saddle Joint Arthrosis (Rhizarthrosis): Prevention

Thumb Saddle Joint Arthrosis (Rhizarthrosis): Analgesics, Anti-Inflammatories

Therapeutic Objective Relief of symptoms Therapy recommendations For non-active rhizarthrosis: analgesic/pain reliever paracetamol (best tolerated). In activated rhizarthrosis (abraded cartilage or bone material inflamed): nonsteroidal anti-inflammatory drugs (NSAIDs), e.g., selective COX-2 inhibitors (e.g., etoricoxib) or diclofenac [no long-term therapy!]Note: No diclofenac in cardiovascular risk! Affected are patients with heart failure (cardiac insufficiency) of NYHA classes … Thumb Saddle Joint Arthrosis (Rhizarthrosis): Analgesics, Anti-Inflammatories

Thumb Saddle Joint Arthrosis (Rhizarthrosis): Symptoms, Complaints, Signs

The following symptoms and complaints may indicate rhizarthrosis (thumb saddle joint arthritis): Leading symptoms The thumb feels unstable or wobbly. Shooting pain Lack of strength in opposition movements (“key grip”; the thumb touches the fingertips of the other fingers) or weakness of grip. Painful restriction of movement Loss of sensitivity Adduction contracture (limb is splayed … Thumb Saddle Joint Arthrosis (Rhizarthrosis): Symptoms, Complaints, Signs