First Carpometacarpal Joint Osteoarthritis: Difference between revisions
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*Power, pincer strength may be reduced | *Power, pincer strength may be reduced | ||
*Grind test: Hold the 1st metacarpal, move the thumb in a circular motion, and apply axial compression | *Grind test: Hold the 1st metacarpal, move the thumb in a circular motion, and apply axial compression | ||
==Differential Diagnoses== | |||
{{Subacute Radial Sided Pain DDX}} | |||
==Investigations== | ==Investigations== | ||
Revision as of 07:51, 29 June 2020
Aetiology
The first CMCJ is highly mobile which is probably linked to an increased rate of degeneration. There is also an association with hypermobility
Epidemiology
Increases with age, most common in postmenopausal women. The female to male ratio is 6:1.1
Assessment
- Base of thumb pain
- Activity related particularly gripping, using taps and door knobs, unscrewing lids, turning keys, sewing.
- Thumb weakness
- Examination
- Deformity at the base of the first MCPJ.
- Adduction of the 1st metacarpal may occur which is visualised by a reduced 1st web space and hyperextension of MCPJ.
- Palpate for tenderness, crepitation, and subluxation
- Range of motion
- Power, pincer strength may be reduced
- Grind test: Hold the 1st metacarpal, move the thumb in a circular motion, and apply axial compression
Differential Diagnoses
Template:Subacute Radial Sided Pain DDX
Investigations
Xray Inflammatory and rheumatological blood tests if required.
Management
- Activity Modification
- Hand Therapy
- Steroid Injection
- Surgery
