Arthritis
What is Arthritis?
What does someone with arthritis complain of?
What to expect post operatively?
If surgery is performed, Hand therapy is absolutely essential.
The therapists also provide patients with splints with advice on how to use them.
When to refer?
Early referral is better when some intervention may minimize morbidity and maintain function. You can refer yourself or get a referral letter from your GP.
Osteoarthritis refers to the process of degeneration of the cartilaginous joint surfaces and hypertrophy (increase of prominence) of bone at the articular margins. It is also referred to as degenerative joint disease.
The cause is unknown.
Surprisingly there may not be much inflammation when compared to the other common form of arthritis (rheumatoid arthritis)
This is common in females and there is often a family history of similar condition of the fingers.
As the normal ‘wear and tear’ with daily use gets worse with increasing age, this form of arthritis presents more in older patients. The distal or furthest joint in the finger and the base of the thumb are the most commonly affected.
Traumatic arthritis is very similar to osteoarthritis except that there is a history of a preceding injury specifically to the involved joint (s).
Rheumatoid arthritis is a systemic autoimmune (body fighting itself) disease of unknown cause. It is marked by painful, inflammatory reaction with destruction of the joint. It causes significant deformities of the hands. Younger patients (20 to 40 years) are predominantly affected.
It is more common in females. Many other important and inner structures such as the tendons, heart and lungs can also be affected
How is it treated?
The treatment varies with type. This usually involve a combination of non surgical and surgical methods.
Non surgical methods include rest, splintage, physiotherapy, analgesics and various medications depending on type (non steroidal anti-inflammatory agents, intra-articular steroid injections, disease modifying drugs)
Surgery depends on type of arthritis and aims to relieve intractable pain and improve function. The range include joint replacements, tendon repair or transfer, fusion, synovectomy (removal of the ‘flimsy gluey’ tissue around the tendons) etc.
The necessary surgery will be discussed during the consultation.
Obviously the underlying condition such as psoriasis is also treated
Anaesthesia
This depends on the kind of surgery required. Local anaesthetics in form of injections to numb only the finger (ring block), the whole arm (regional anaesthesia or brachial block) and general anaesthesia are all used when necessary.