Dr. Mark E. Pruzansky
Dr. Jason S. Pruzansky
975 Park Avenue New York, NY 10028

Basal Joint Arthritis

Basal Joint Arthritis 1

Image of the Basal Joint.

What is Thumb Basal Joint Arthritis?

The Thumb Basal Joint is the joint at the base of your thumb where it meets your wrist. Basal Joint Arthritis is the result of cartilage wear inside the joint. The bottom end of the thumb metacarpal bone normally glides smoothly on a small bone in the wrist called the trapezium. When arthritis sets in, the bones no longer move smoothly against each other. The arthritis causes joint inflammation, which leads to pain. The ligaments that hold the joint together can become damaged from the inflammation and stretch out, allowing the joint to partially move out of place. This leads to limited motion and visible deformity in later stages.

Symptoms of Thumb Basal Joint Arthritis

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Preoperative photo of a patient with basal joint arthritis.

Pain and swelling are common early symptoms due to inflammation in the arthritic joint. This is usually felt the most at the base of the thumb where it meets the wrist. Deformity of the thumb and stiffness can develop as the arthritis becomes more severe. The symptoms from Basal Joint Arthritis usually don’t develop until middle age or older.

Common Causes of Thumb Basal Joint Arthritis

The arthritis can develop because of years of strenuous use, a history of prior trauma, or represent a common change that occurs with increasing age. The Thumb Basal Joint normally allows for a large range of motion of the thumb. Furthermore, the force exerted at the tip of your thumb when pinching or pressing on something is magnified to a much greater force at the Thumb Basal Joint because of the mechanics of your thumb anatomy. Due to this high joint mobility and the heavy loading it experiences frequently the Thumb Basal Joint is a very common site for arthritis in the hand. Women are usually affected by this condition more often than men due to their increased joint laxity and genetic predisposition.

Diagnosing Thumb Basal Joint Arthritis

Speaking with you and performing a careful physical examination of your hand and wrist are central to the diagnosis. X-rays are also commonly used to confirm the diagnosis and evaluate the severity of the arthritis.

Treatment Options for Thumb Basal Joint Arthritis

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Surgical exposure of osteoarthritis of the trapeziometacarpal joint (basilar joint), preparing for suspension arthroplasty.

Initial treatment with occupational therapy, intermittent splinting, anti-inflammatory medication, and a cortisone injection can reduce symptoms. The arthritis itself cannot be made to go away, but why treating the inflammation from the arthritis pain can often be reduced. Resistant cases in which the thumb pain is limiting use of the hand and affecting quality of life can be treated with arthroscopic surgery or a minimally invasive surgical arthroplasty. Surgery typically involves removing the arthritic trapezium bone (which is one half of the Thumb Basal Joint) and using a nearby tendon to resurface and reconstruct the joint. Surgery generally eliminates the pain and greatly improves use of the thumb and function of the hand.

Conclusion

Thumb Basal Joint Arthritis is very common and can make use of your hand difficult. Call Dr. Pruzansky at 212-249-8700 to schedule an appointment in order to try and improve your form and function.