Hand And Wrist Arthritis Diagnosis
Our orthopedic surgeons are experts at diagnosing the full range of hand and wrist arthritis problems. Our initial exam generally includes:
- Taking your medical history: This includes asking questions about when your pain began, whether it affects one or both sides of your body, and when the pain feels most severe. Other questions may be about whether you have other medical problems, and if you take any medications.
- Physical exam: The orthopedist will examine your affected hand, wrist, or elbow.
- Imaging tests: Your orthopedist may want to examine the bones and joints themselves using an X-ray, CT scan, or MRI.
What Is Osteoarthritis Of The Hand
- The base of your thumb, where it meets your wrist
- One of the joints closest to your fingertips
- The middle joint of a finger
There’s no cure, but there are a lot of ways to protect your joints and feel better.
Without treatment, osteoarthritis gets worse over time. Itâs important to get a diagnosis and a treatment plan as soon as possible.
What If Conservative Management Does Not Work
Injection therapy is an effective tool for reducing pain and inflammation associated with wrist joint osteoarthritis. It is considered an appropriate treatment option when conservative management has failed to reduce symptoms, or when:
- Pain has persisted for over 3 months
- Pain is limiting you from embarking in a physiotherapy rehabilitation
- Pain is limiting you from completing activities of daily living including work and sporting activities
- Pain is affecting your sleep
At Complete all injection techniques are performed under ultrasound guidance. Dynamic, real-time ultrasound imaging is used to accurately and effectively guide a needle directly to the source of your pain. Research has proven ultrasound guided injections to be more accurate, have less side effects and more effective at reducing pain than land marked injections.
All clinicians at Complete are experienced in performing ultrasound-guided injections for wrist osteoarthritis. Complete run a same-day service on all ultrasound-guided injections. You do not need a referral from a doctor or bring a prescription. Your clinician is a qualified independent prescriber and will be able to prescribe the most effective medication for you.
There are two main injection options available for the treatment of osteoarthritis of the wrist:
Ultrasound-guided corticosteroid injection
Ultrasound-guided hyaluronic acid injection
Other Wrist & Hand conditions:
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What Causes Arthritis Of The Wrist
Osteoarthritis can develop due to normal wear-and-tear in the wrist, particularly in people who have a family history of arthritis. It may also develop as a result of a traumatic injury, such as a broken wrist bone or a wrist sprain.
Osteoarthritis of the wrist can also develop from Kienböcks disease. In Kienböcks disease, the blood supply to one of the small bones of the hand near the wrist is interrupted. If the blood supply to a bone stops, the bone can die. Over time, this can lead to osteoarthritis.
The exact cause of RA is not known. There may be a genetic reason some people may be more likely to develop the disease because of family heredity. However, doctors suspect that it takes a chemical or environmental trigger to activate the disease in people who genetically inherit RA.
How Arthritis In The Wrist Is Diagnosed
First, your doctor will ask about your symptoms and medical history and perform a physical exam. During your physical exam, your doctor will examine your wrist for swelling and pain.
Next, your doctor will examine the range of motion of the wrist itself. Your doctor may have you twist and flex both wrists in every direction to assess your range of motion. They will manipulate your wrist and thumb joints and ask if you feel pain in your wrists and thumbs. This exam can show how mild or severe the arthritis is, or if another condition is causing symptoms, such as carpal tunnel syndrome or tendinitis.
If your doctor suspects inflammatory arthritis, they will order blood tests to detect the presence of certain antibodies, such as rheumatoid factor or anti-CCP, which help identify RA and other types of inflammatory arthritis. They may also order blood tests that look for levels of inflammation, such as C-reactive protein and erythrocyte sedimentation rate .
Your doctor may order imaging tests, such as X-rays or MRIs, to assess whether you have joint damage in the wrist.
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Weight Management And Diet
Although the link between your weight and osteoarthritis of the hands may be less clear than for weight-bearing joints such as the knees, some research shows that being overweight increases inflammation and therefore pain. Therefore, if you have osteoarthritis of the hand or wrist, it still makes sense to try to maintain, or achieve, a healthy weight.
What Are The Most Common Treatments
The treatment for your wrist or hand lump can depend on the condition thats causing it. Your doctor will work to come up with a treatment plan thats right for you. Possible treatments can include:
- Over-the-counter medications. You may be able to use OTC medications to relieve pain and inflammation. Common OTC drugs include acetaminophen , ibuprofen , and naproxen .
- Prescription medications. Sometimes your doctor may prescribe a medication like oral or injected corticosteroids or specialized medications for conditions like RA.
- Immobilization. A splint or brace can be used to immobilize your wrist or hand. This may be used when movement causes pain or causes a cyst or tumor to get larger.
- Aspiration. In some cases, the fluid in a lump may need to be drained using a needle. This may be done for ganglion cysts and epidermal inclusions.
- Physical therapy. This can include exercises to help increase your range of motion and improve strength in your hands or wrist. Physical therapy can be particularly helpful for osteoarthritis, RA, or while recovering from surgery.
- Surgery. Your doctor may choose to remove the lump surgically. This may be done for a variety of conditions, including ganglion cysts and other types of cysts or tumors. Also, conditions that cause lumps, such as trigger finger and carpal boss, may also be treated surgically.
- Cancer therapies. When a tumor is malignant, the most common types of treatment include surgery, radiation therapy and chemotherapy.
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What Steps Are Used To Diagnose Ra In The Wrist
Diagnosis begins with an evaluation of the wrist, including palpation and a range-of-motion evaluation to pinpoint the area of the joint where the pain is located. Diagnostic imaging will be ordered to evaluate and inspect the interior of the wrist joint and blood testing also may be performed. Blood tests can be useful in identifying specific antibodies associated with RA.
What Are The Symptoms Of Arthritis Of The Elbow
Symptoms of elbow arthritis can include:
- Pain. In the early stages of rheumatoid arthritis, pain may be primarily on the outer side of the joint. Pain generally gets worse as you turn your forearm. The pain of osteoarthritis may get worse as you extend your arm. Pain that continues during the night or when you are at rest indicates a more advanced stage of osteoarthritis.
- Swelling. This is more common with rheumatoid arthritis.
- Instability. The joint isn’t stable and gives way, making it difficult or impossible to do normal daily activities.
- Lack of full movement. You are not able to straighten or bend the elbow.
- Locking. Your elbow joint catches or locks. This can happen with osteoarthritis.
- Stiffness. This happens particularly with arthritis that develops after an injury.
- Pain in both elbows. Having pain in both elbows or pain at the wrists or shoulders as well as pain in the elbows is a symptom of rheumatoid arthritis.
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Hand And Wrist Arthritis Treatment
Treatment for hand, wrist, and elbow arthritis usually depends on whether you suffer from osteoarthritis or rheumatoid arthritis, and how severe your disease is. The experienced team of orthopedists at MedStar Health will examine you carefully and work to develop the most effective treatment plan for you, to ease your pain and improve your ability to use your hands and wrists.
Treatment options aside from surgery may include:
- Prescription and over-the-counter anti-inflammatory medications
- Injections of steroids or anti-inflammatory medications
- Temporarily restricting hand or wrist movement with a splint to ease pain
- Physical therapy
If non-surgical treatment does not relieve your pain, you may need surgery. The orthopedic surgeons at MedStar Georgetown are experienced in the most advanced and innovative surgical procedures for arthritis treatment.
Surgical procedures we use to treat arthritis include:
How Are Lumps On The Hand Or Wrist Diagnosed
In order to diagnose the cause of your lump, your doctor will first take your medical history. Theyll ask you things like when you first noticed the lump, whether it has changed in size, and if youre experiencing any symptoms.
- Physical examination. Your doctor will examine your lump. They may press on the lump to check for pain or tenderness. They may also shine a light on the lump to help them see if its solid or filled with fluid.
- Imaging. Your doctor may also want to use imaging technology to get a better view of the lump and the surrounding tissue. This can include things like an ultrasound, MRI, or X-ray.
- Biopsy. In the case of a cyst or tumor, your doctor may want to take a tissue sample to examine the cells.
- Laboratory tests. Blood tests can help diagnose some conditions like RA and gout.
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Enhancing Healthcare Team Outcomes
Wrist arthritis can be challenging in terms of both diagnosis and management. Since hand motions are essential for many higher functions, providers must pay close attention to details while addressing wrist arthritis in a time-sensitive manner to prevent disability. One should consider an interprofessional approach involving rheumatologists, orthopedic surgeons, physical therapists, and occupational therapists whenever appropriate.
While the patient may initially be seen by the primary care provider or the nurse, it is important to refer the patient to the rheumatologist or orthopedic surgeon to confirm the diagnosis the earlier the treatment, the better the outcomes. The pharmacist should educate the patient on drug compliance and check for drug-drug interactions. The team should communicate with each other regarding the treatment steps.
When Hand Or Wrist Pain May Mean Arthritis
Learn about the various causes of hand or wrist pain, including different kinds of arthritis.
Many forms of arthritis and related conditions that affect different parts of the hands. Common symptoms include pain, stiffness, swelling or numbness in the wrist and fingers. Pitted nails, painful ulcers or thickened skin that makes bending the fingers difficult may also occur. Here are some diseases that affect the hands.
Osteoarthritis is the most common form of arthritis. Also known as wear and tear arthritis, OA is a chronic condition caused by the breakdown of the cartilage, which cushions the ends of the bones where they meet to form joints. This breakdown causes the bones to rub together, causing stiffness, pain and loss of joint movement.
In hand OA, the joints most commonly affected by OA are the wrists, the joints at the base of the thumb, the middle finger joints and the joints closest to fingernails. In the finger joints, OA can lead to the formation of nodes .
Rheumatoid arthritis is a chronic inflammatory disease caused by a faulty immune system that primarily attacks joints . The result can be joint pain, swelling, inflammation and loss of function. RA commonly affects the wrist and finger joints. RA usually affects the same joint on both sides of the body . If untreated, the disease can cause joint deformities that make it difficult to use the hands.
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How Is Hand And Wrist Arthritis Diagnosed
Your consultant will carry out a physical examination to assess your wrist and hand for pain, swelling and loss of movement. Depending which parts of the wrists are affected , the swelling may be in a different place. You may be asked to twist and flex your wrists to ascertain whether the pain is in your wrists or thumbs. An X-ray will confirm the diagnosis and can identify bone spurs and worn down cartilage. You may also be given a blood test to determine whether you have rheumatoid arthritis or osteoarthritis. An ultrasound sometimes will help to confirm tendon irritation or joint inflammation.
Hand Osteoarthritis Home Remedies
These home treatments can help:
- Exercises. Your doctor or physical therapist can show you what to do to improve strength and range of motion and to ease pain.
- Assistive devices. Special pens, kitchen utensils, and other tools with big grips may be easier to use.
- Ice or heat. Ice may reduce swelling and pain. Heat, like a warm washcloth or a paraffin bath, can loosen stiff joints.
- Skin treatments. Medicated creams can give relief when you rub them on sore joints. Gels with nonsteroidal anti-inflammatory drugs also help.
- Supplements. Many people take glucosamine and chondroitin supplements for OA. Researchers are still looking into whether they help. Ask your doctor if they’re OK to try.
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How Do You Treat Arthritis In The Fingers Hand Or Wrist
Treatment for arthritis of the hand, wrist or fingers depends on avariety of factors. Including:
- How far the arthritis hasprogressed
- How many joints are involved
- Your age or other medicalconditions
- Activity level
- If your dominant ornon-dominant hand is affected
Nonsurgical treatment options
- Medications: The most commonmedications for arthritis are anti-inflammatories, such as ibuprofen oraspirin, which stops the body from producing chemicals that cause jointswelling and pain.
- Rheumatology doctor: A rheumatologist hasspecial training in diseases that affect your joints, muscles and bones,including arthritis.
- Injections: An injection typicallycontains a steroid and long-lasting anesthetic which can provide pain relieffor weeks to months. Injections can be repeated but only a limited number oftimes during a certain time period.
- Splinting: Splinting can be used inconjunction with injections to help support the arthritic joint. Splints areusually worn during periods where the joint hurts however, wearing a splintnon-stop can lead to muscle deterioration. Therefore, a splint should stillallow functional use of the hand and be removed when periods of pain subside.
- Hand therapy: A hand therapist can teachyou exercises to help you move your wrist or hand and make them stronger. Theycan also show you how to ease the strain on your hand or wrist during yourdaily or work activities.
Surgical treatment for hand or wrist arthritis
Physical Examination Of Wrist Pain Causes
Doctors examine the wrist to find the most tender spot. Also, special tests are useful to confirm or rule out causes. For example, Watsons test is useful for ligament injury and Finkelsteins test is used for De Quervains tenosynovitis.
Also examining above the wrist in the elbow, shoulder, and neck is important to exclude referred pain.
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Wrist Arthritis Management In North Dakota
Pain every now and then is a normal part of life. However, pain caused by wrist arthritis can be debilitating and should not be ignored. If you notice you have any of the symptoms associated with arthritis in your wrist, seek help from an orthopedic physician. There are many ways to manage wrist arthritis so it doesnt take over your life.
The Bone & Joint Center in North Dakota specializes in problems associated with bones and joints, including arthritis. Our board-certified orthopedic doctors have years of experience in diagnosing and treating conditions affecting the hands, wrists, and elbows, among others. We also offer physical and occupational therapy for our patients. We have 11 clinics in North Dakota ready to serve you.
You may reach us at 946-7400 or 900-8650. You may also use this secure online form to schedule an appointment with ease.
Alternative Remedies For Wrist Arthritis
Wrist arthritis treatment is designed to minimize the symptoms. In the majority of cases, treatment begins with non-surgical approaches. Wrist arthritis alternative remedies are not radical in nature. In fact, they are treatments that are often used for other ailments.
The following list outlines potential treatment options, including some alternative remedies.
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What Causes Ra In The Wrist
The specific underlying cause of RA including the event that triggers the immune system to malfunction is not well understood. When the disease occurs, symptoms begin with an inflammatory response inside the joint caused by the attacking immune cells. This inflammation results in swelling and pain, especially when the joint is used. Eventually, the inflamed tissues inside the joint begin to thicken, creating increased friction inside the joint that exacerbates the inflammation and painful symptoms.
Without proper treatment, the cartilage that covers the ends of the bones inside the joint can begin to wear away, and the space between the bones become smaller. Over time, the ends of the bones become exposed and pain increases significantly. As the inflammation, swelling and damage continue, joint deformity often occurs.
How Are The Hands And Wrists Structured
There are 27 small bones that make up each hand and wrist. Eight of those bones are in your wrist. Each finger has three bones, and the thumb has two. There are five bones in the palm of your hand, connecting each finger and the thumb with the wrist.
There are more than 30 muscles that control the hand and wrist. These are in your hands, wrists and forearms.
Muscles are attached to bones by tendons. These are small but very tough pieces of connective tissue. Tendons pass through a bony passage in your wrist, known as the carpal tunnel. The median nerve also passes through this tunnel.
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