Orthopaedic Surgeon, Orange County CA, Carpal Tunnel Syndrome, Wrist injuries, Work Comp Dr. What is MP Joint Arthritis? They act as complex hinge joints and are important is arthrosis arthritis both power grip and pinch activities.
The most common arthritic condition affecting the MP joints is rheumatoid arthritis. Less commonly, other conditions can produce pain, deformity, and motion loss. Similar findings are seen with osteoarthritis. Post-traumatic and osteo-arthritis most commonly affect the thumb, index, and middle fingers, and the degree of deformity is often much less severe than in rheumatoid arthrosis.
Gout, psoriasis, and infection are other less common causes of MP joint arthritis. Most patients with rheumatoid arthritis present with longstanding pain, swelling, and deformity in multiple joints of both the upper and lower extremities. Incasesofosteoarthritis and post-traumatic arthritis, patients usually complain of deep, aching joint pain that is worsened by grip and pinch activities. Many of these patients will not have an obvious finger deformity, although swelling, especially in the spaces between the large knuckles, is often present. Special x-rays to look carefully at the metacarpal head are also helpful, particularly in milder cases.
Figure 3: X-ray of MP joint arthritis. Various treatment alternatives are available, based upon the degree of the joint destruction and the patient’s complaints. In cases of rheumatoid arthritis, there are a variety of medications that are very effective in combating the generalized inflammatory process. If medication fails to reduce symptoms or slow the destructive process, direct cortisone injections used judiciously can offer temporary improvement.
Similarly, in cases of post-traumatic arthritis, anti-inflammatory medication, activity modification, and simple splints can provide patients with symptom relief. In cases of progressive pain, deformity, and motion loss despite medical management, certain patients may be candidates for surgical treatment. Patients with rheumatoid disease at a stage without significant joint surface destruction may benefit from synovectomy, in which the active, inflamed lining tissue of the joint, the joint synovium, is removed in order to slow the destructive process and maintain joint cartilage. Patients with severe joint destruction may benefit from either a joint fusion or joint replacement. The thumb functions very well after an MP joint fusion. In the fingers, however, the loss of motion can be very disabling and joint replacement is usually preferred.