Diagnosis of saddle joint arthrosis
definition
In the case of saddle joint arthrosis (Rhizarthrosis), it is an osteoarthritis of the joint between the first metacarpal bone (Os metacarpal I) and the large polygonal bone belonging to the carpal bones (Trapezium). The affected palms are saddle-shaped and allow the joint to move in two axes. The combination of both axes results in a mobility that is almost like that of a ball joint.
The arthrosis of the thumb saddle joint caused by wear and tear of the joint surfaces is the most common osteoarthritis of the hand This disease is present in about 10% of the population, whereby Women affected 10 times more often are as men. Osteoarthritis usually occurs both sides on.
diagnosis
The clinical picture provides the doctor with an initial indication of damage to the thumb saddle joint Pain and Weak grip of the thumbwhich already causes problems in the early stages. Initially, an increasing weakness of the thumb dominates, which makes it difficult to lift objects with the thumb, index and middle finger or to open bottles. Pain soon set in, which occurs in the early stages, especially under stress. As the disease progresses, this pain persists even after the end of the exertion and can occur at night.
Of the advanced finding an osteoarthritis of the thumb saddle can already be recognized during inspection. There is one visible deformation and swelling of the joint in front. When palpating (palpation) the patient indicates pain. With axial Applying pressure on the thumb with simultaneous Internal and external rotations (Grind test) is an osteoarthritis of the thumb saddle joint Grating and grinding to feel. Here, too, the patient reports pain.
The radiological examination provides im X-ray image the typical Osteoarthritis sign: Narrowing of the joint space, compression of the bone below the cartilage layer (subchondral sclerosis), bone protrusions at the edge of the joint surfaces (osteophytes) and cysts. In the initial stage, the X-ray image may still be normal. Here the cartilage of the articular surfaces is still intact.
Since a computed tomogram (CT) causes a higher radiation exposure than a conventional X-ray and a magnetic resonance tomography (MRT) is more complex and expensive, these two sectional imaging methods are usually not indicated and are only used if the diagnosis is uncertain.
To get the isolated thumb saddle joint arthrosis from a rheumatoid arthritis (rheumatoid arthritis - inflammation of several joints) can be a Blood collection become necessary. If rheumatoid arthritis is present, it is 80% of the time Rheumatoid factor detectable in the blood.
If the person concerned also complains nocturnal sensory disturbances and pain, will also be a neurological examination necessary because the thumb saddle joint arthrosis with a Carpal tunnel syndrome can be connected.
Appointment with a hand specialist?
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Who am I?
My name is dr. Nicolas Gumpert. I am a specialist in orthopedics and the founder of .
Various television programs and print media report regularly about my work. On HR television you can see me every 6 weeks live on "Hallo Hessen".
But now enough is indicated ;-)
In order to be able to treat successfully in orthopedics, a thorough examination, diagnosis and a medical history are required.
In our very economic world in particular, there is too little time to thoroughly grasp the complex diseases of orthopedics and thus initiate targeted treatment.
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The aim of any treatment is treatment without surgery.
Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.
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