Finger anatomy is intricate. The bones in the palm of the hand are called metacarpal bones -- one metacarpal connects to each finger and thumb. Each finger is made of small bone shafts, called phalanges. The knuckle joints closest to the wrist (metacarpophalangeal or MCP joints) are formed by the connection of the phalanges to the metacarpals. The MCP joint functions like a hinge when the fingers are bent or straightened.
The three phalanges in each finger are separated by two joints, called interphalangeal or IP joints. The one closest to the MCP is called the proximal interphalangeal or PIP joint. The joint near the end of the finger is called the distal interphalangel or DIP joint. IP joints also work like hinge joints. (Illustration)
We take our fingers and hands for granted. During a typical day, notice how much activity depends on hand motion. Recognize the complexity of each movement and how difficult daily activities become for people living with finger osteoarthritis.
Cause of Finger Osteoarthritis
Osteoarthritis is a degenerative joint disease. With this type of arthritis, cartilage -- a tough, but flexible tissue that covers the ends of the bones forming a joint -- wears away gradually. Injury to a joint (sprain or fracture) can cause damage to cartilage. Even if injury does not directly cause cartilage damage, it can affect how the joint works. Joints can be misaligned after they heal from an injury. Such abnormalities can stress the joint, which can later damage cartilage.
Diagnosis of Finger Osteoarthritis
The diagnosis of finger osteoarthritis typically starts with a medical history -- a history of any injuries that may have caused the condition. A physical exam lets the doctor evaluate the range of motion in the affected finger joints and what movements provoke pain. The appearance of characteristic nodes (Bouchard's or Heberden's nodes) may also help with the diagnosis of finger osteoarthritis.
X-rays are usually ordered so the doctor can see images of joint damage, especially to establish how much cartilage remains or if the joint is bone-on-bone (as in the cartilage completely worn away).
Symptoms of Finger Osteoarthritis
Symptoms associated with finger osteoarthritis include:
- the development of nodes
- limited range-of-motion
- decreased grip strength
Typically, osteoarthritis pain is felt at the start of an activity, then it diminishes as the activity progresses. After the activity has stopped and during rest, pain and stiffness usually return. With advanced osteoarthritis, pain can be felt even at rest.
Treatment of Finger Osteoarthritis
Pain is usually the symptom that causes patients to seek treatment. Early treatment can help manage finger osteoarthritis. Conservative treatment measures are tried first, including:
- anti-inflammatory medications such as aspirin or NSAIDs
- reducing activity levels
- changing actitivites or occupations that require repetitive finger motion
- cortisone injection into the joint
- physical therapy including range-of-motion and strengthening exercises
- occupational therapy
- topical rubs
When conservative treatment fails to produce satisfactory relief, surgery may be the last resort treatment option. Surgery is indicated for patients with uncontrolled pain that affects normal hand function. Surgical options for finger osteoarthritis include arthrodesis (fusion) or joint replacement, depending on the affected joint.
Arthritis of the Finger Joints. eOrthopod. Accessed 2/8/2008. Osteoarthritis of the Fingers. Estes JP. Journal of Hand Therapy. April-June 2000.
Arthritis of the Finger Joints. eOrthopod. Accessed 2/8/2008.
Osteoarthritis of the Fingers. Estes JP. Journal of Hand Therapy. April-June 2000.