{"id":4227,"date":"2022-05-03T11:47:20","date_gmt":"2022-05-03T10:47:20","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/osteoarthritis-hand\/"},"modified":"2024-09-17T11:12:31","modified_gmt":"2024-09-17T10:12:31","slug":"osteoarthritis-hand","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/plasticsurgery\/handsurgery\/osteoarthritis-hand\/","title":{"rendered":"Osteoarthritis – Hand"},"content":{"rendered":"\n

This page was last reviewed 13-08-20<\/strong><\/p>\n\n\n\nOsteoarthritis – Hand<\/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 and\nthe 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.<br><\/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>Thumb base arthritis<\/li>\n\n\n\n<li>Digital arthritis<\/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\n\n\n<li>Early intermittent pain not requiring any intervention<\/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<p>After using an XRAY to confirm diagnosis, and intial early management as per primary care management tab, refer to:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Thumb base arthritis clinic for CMC joint arthritis\n<ul class=\"wp-block-list\">\n<li>Run by Allied Health Professional under supervision of consultant hand surgeon<\/li>\n<\/ul>\n<\/li>\n\n\n\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\">Primary Care Management<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p>Advise the patient on analgesia, activity modification, and using a thumb base splint for at least 3-6 months.<\/p>\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\" target=\"_blank\" rel=\"noreferrer noopener\">Plastic Surg \u2013 PIL BSSH CARPAL TUNNEL Aug18opens a new window<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/BSSH-GANGLIA.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Plastic Surg \u2013 PIL BSSH GANGLIA Aug18opens a new window<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/BSSH-OA-THUMB.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Plastic Surg \u2013 PIL BSSH OA THUMB Aug18opens a new window<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/BSSH-TRIGGER-FINGER.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Plastic Surg \u2013 PIL BSSH TRIGGER FINGERAug18opens a new window<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/www.nice.org.uk\/\" target=\"_blank\" rel=\"noreferrer noopener\">National Institute for Health and Care Excellence (NICE)opens a new window<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/www.guidelinesinpractice.co.uk\/home\/the-scottish-intercollegiate-guidelines-network-sign\/305547.article\" target=\"_blank\" rel=\"noreferrer noopener\">Scottish Intercollegiate Guidelines Network (SIGN)opens a new window<\/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 href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/PatientInformation\/BSSH%20OA%20THUMB.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">BSSH OA THUMB<\/a><\/li>\n<\/ul>\n<\/div><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>This page was last reviewed 13-08-20 Osteoarthritis – Hand 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":[560],"class_list":["post-4227","page","type-page","status-publish","hentry","category-osteoarthritishand"],"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\/osteoarthritishand\/\" rel=\"tag\">Osteoarthritis - Hand<\/a>","rttpg_excerpt":"This page was last reviewed 13-08-20 Osteoarthritis – Hand 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\/4227","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=4227"}],"version-history":[{"count":5,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4227\/revisions"}],"predecessor-version":[{"id":20894,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4227\/revisions\/20894"}],"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=4227"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=4227"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}