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Trapeziometacarpal osteoarthritis (TMC OA) is, also known as osteoarthritis at the base of the thumb, thumb carpometacarpal osteoarthritis, basilar (or basal) joint arthritis, or as rhizarthrosis. [ 3 ] [ 1 ] [ 2 ] This joint is formed by the trapezium bone of the wrist and the metacarpal bone of the thumb.
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This is often remembered by the mnemonic PAD-DAB, as the Palmar interosseous muscles ADduct, and the Dorsal interosseous muscles ABduct. The axial line goes down the middle of the 3rd digit, towards the palm of the hand (it's an imaginary line). Both sets of muscles are innervated by the deep branch of the ulnar nerve. [1]
The neck of a metacarpal is a common location for a boxer's fracture, but all parts of the metacarpal bone (including head, body and base) are susceptible to fracture. During their lifetime, 2.5% of individuals will experience at least one metacarpal fracture. Bennett's fracture (base of the thumb) is the most common. [4]
Carpometacarpal bossing (or metacarpal/carpal bossing) is a small, immovable mass of bone on the back of the wrist. The mass occurs in one of the joints between the carpus and metacarpus of the hand , called the carpometacarpal joints , where a small immovable protuberance [ 1 ] occurs when this joint becomes swollen or bossed.
A boxer's fracture is the break of the fifth metacarpal bone of the hand near the knuckle. [4] Occasionally, it is used to refer to fractures of the fourth metacarpal as well. [1] Symptoms include pain and a depressed knuckle. [2] Classically, it occurs after a person hits an object with a closed fist. [3]
[1] [2] If sharp pain occurs along the distal radius (top of the forearm, about an inch below the wrist), de Quervain syndrome is likely. While a positive Finkelstein test is often considered pathognomonic for de Quervain syndrome, the maneuver can also cause some pain in those with osteoarthritis at the base of the thumb. [2]
It presents on its base one facet on its superior surface, which is concavo-convex and articulates with the hamate, and one on its radial side, which articulates with the fourth metacarpal. On its ulnar side is a prominent tubercle for the insertion of the tendon of the extensor carpi ulnaris muscle .
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