{"id":4224,"date":"2022-05-03T11:47:20","date_gmt":"2022-05-03T10:47:20","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/osteoarthris-wrist\/"},"modified":"2026-04-14T14:15:21","modified_gmt":"2026-04-14T13:15:21","slug":"osteoarthrits-wrist","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/plasticsurgery\/handsurgery\/osteoarthrits-wrist\/","title":{"rendered":"Osteoarthritis – Wrist"},"content":{"rendered":"\n

This page is currently under review<\/strong><\/strong><\/strong><\/p>\n\n\n\nOsteoarthris – Wrist<\/title>\n\n\n\n<p><span>Joint inflammation is indicated by pain, swelling, stiffness and loss of\nfunction, that can result from degenerative osteoarthritis (OA) or systemic,\nautoimmune arthritis. The former commonly affects the thumb base CMC joints\nand the DIP joints (Heberden\u2019s nodes) or PIP joints (Bouchard\u2019s nodes) of the\nfingers. Middle age and older adults are predominantly affected although other\nrisk factors include previous major or repetitive joint trauma or joint\ninstability. Management is primarily conservative, making use of rest,\nanti-inflammatory medications and splints for use at night and during specific\nactivities. Physiotherapy is often helpful.<\/span><\/p>\n\n\n\n<div class=\"wp-block-getwid-tabs\" data-active-tab=\"0\"><ul class=\"wp-block-getwid-tabs__nav-links\"><\/ul>\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Referral Guidelines<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<h3 class=\"wp-block-heading\">What we will see<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Diagnostic difficulties<\/li>\n\n\n\n<li>Patients with a diagnosis of Rheumatoid arthritis who are having functional issues with their hands<\/li>\n\n\n\n<li>Pain unresponsive to simple non-interventional measures<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\">What we won’t see<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Straightforward diagnosis with no functional deficit<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\">Specific tests<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Clinical examination of joint \u2013 palpation, range of movement<\/li>\n\n\n\n<li>X-ray of affected part (be specific about digit and joint on request)<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\">Trial of therapy pre-referral<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>If no functional deficit then no treatment required<\/li>\n\n\n\n<li>Trial of oral analgesia or topical NSAID gel<\/li>\n\n\n\n<li>Activity modification<\/li>\n\n\n\n<li>Consider appropriate splintage<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\">Whom to direct referral to<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Any hand surgeon<\/li>\n<\/ul>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Resources and Links<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<ul class=\"wp-block-list\">\n<li><a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/BSSH-CARPAL-TUNNEL-1.pdf\" data-type=\"URL\" data-id=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/BSSH-CARPAL-TUNNEL-1.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Plastic Surg \u2013 PIL BSSH CARPAL TUNNEL Aug18<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/BSSH-GANGLIA.pdf\" data-type=\"URL\" data-id=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/BSSH-GANGLIA.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Plastic Surg \u2013 PIL BSSH GANGLIA Aug18<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/BSSH-OA-THUMB.pdf\" data-type=\"URL\" data-id=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/BSSH-OA-THUMB.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Plastic Surg \u2013 PIL BSSH OA THUMB Aug18<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/BSSH-TRIGGER-FINGER.pdf\" data-type=\"URL\" data-id=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/BSSH-TRIGGER-FINGER.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Plastic Surg \u2013 PIL BSSH TRIGGER FINGERAug18<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/www.nice.org.uk\/\" data-type=\"URL\" data-id=\"https:\/\/www.nice.org.uk\/\" target=\"_blank\" rel=\"noreferrer noopener\">National Institute for Health and Care Excellence (NICE)<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/www.guidelinesinpractice.co.uk\/home\/the-scottish-intercollegiate-guidelines-network-sign\/305547.article\" data-type=\"URL\" data-id=\"https:\/\/www.guidelinesinpractice.co.uk\/home\/the-scottish-intercollegiate-guidelines-network-sign\/305547.article\" target=\"_blank\" rel=\"noreferrer noopener\">Scottish Intercollegiate Guidelines Network (SIGN)<\/a><\/li>\n\n\n\n<li><a rel=\"noreferrer noopener\" href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Wrist-Pain-Algorithm-of-Differential-Diagnoses.pdf\" target=\"_blank\">Wrist Pain Algorithm of Differential Diagnoses<\/a><\/li>\n\n\n\n<li><a rel=\"noreferrer noopener\" href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/PatientInformation\/BSSH%20OA%20THUMB.pdf\" target=\"_blank\">BSSH OA THUMB<\/a><\/li>\n<\/ul>\n<\/div><\/div>\n<\/div>\n\n\n\n<p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>This page is currently under review Osteoarthris – Wrist Joint inflammation is indicated by pain, swelling, stiffness and loss of function, that can result from degenerative osteoarthritis (OA) or systemic, autoimmune arthritis. The former commonly affects the thumb base CMC joints and the DIP joints (Heberden’s nodes) or PIP joints (Bouchard’s nodes) of the fingers.<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":3988,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"categories":[561],"class_list":["post-4224","page","type-page","status-publish","hentry","category-osteoarthriswrist"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"NHS Lothian","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/nhs-lothian\/"},"rttpg_comment":0,"rttpg_category":" <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/plasticsurgery\/handsurgery\/osteoarthriswrist\/\" rel=\"tag\">Osteoarthris - Wrist<\/a>","rttpg_excerpt":"This page is currently under review Osteoarthris – Wrist Joint inflammation is indicated by pain, swelling, stiffness and loss of function, that can result from degenerative osteoarthritis (OA) or systemic, autoimmune arthritis. The former commonly affects the thumb base CMC joints and the DIP joints (Heberden’s nodes) or PIP joints (Bouchard’s nodes) of the fingers.","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4224","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=4224"}],"version-history":[{"count":8,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4224\/revisions"}],"predecessor-version":[{"id":27634,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4224\/revisions\/27634"}],"up":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3988"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=4224"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=4224"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}