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Wrist osteoarthritis is gradual loss of articular cartilage and hypertrophic bone changes (osteophytes). While in many joints this is part of normal aging (senescence), in the wrist osteoarthritis usually occurs over years to decades after scapholunate interosseous ligament rupture or an unhealed fracture of the scaphoid.
Commonly, wrist pain is caused by sudden load-bearing or twisting effects, such as falling from a height with an outstretched hand. [1] Rupture of multiple wrist ligaments in a more severe event may require surgical repair. [1] Injury to and inflammation of the scapholunate ligament is a common wrist injury. [1]
The TMC joint is a synovial joint between the trapezium bone of the wrist and the metacarpal bone at the base of the thumb. This joint is a so-called saddle joint (articulatio sellaris), unlike the CMC joints of the other four fingers which are ellipsoid joints. [17] This means that the surfaces of the TMC joint are both concave and convex.
The theory is that the radial nerve becomes irritated and/or inflamed from friction caused by compression by muscles in the forearm. [1]Some speculate that radial tunnel syndrome is a type of repetitive strain injury (RSI), but there is no detectable pathophysiology and even the existence of this disorder is questioned.
The treatments may include joint replacement surgery for severely damaged joints, immunosuppressants for immune system dysfunction, antibiotics when an infection is the cause, and discontinuing medication when an allergic reaction is the cause. When treating the primary cause, pain management may still play a role in treatment.
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If medications, lifestyle changes, and physical therapy are not enough to reduce the symptoms, especially the pain, surgery and other such interventions for managing post-traumatic arthritis are available. In many cases, joint replacement or cartilage resurfacing are recommended.
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