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Common Wrist & Hand Conditions
OA Thumb
Affected Area
- Progressive onset of stiffness and pain.
- Decreased active range of movement esp abduction/ extension of thumb.
- Pain around base of thumb.
- Thumb often adducted at rest.
- More common on women >55
- Step deformity
- Positive grind test
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- X-ray: AP / lateral of CMCJ
- +/- Wrist X-ray
- Not responding to treatment
- Functional disability significantly affecting work and ADL
- Patient would consider further intervention (US injection/ surgery).
Finger OA
Affected Area
- Pain and/ Stiffness of MCP/ PIP/ DIP joints.
- Commonly caused by OA but can also be caused by inflammatory arthritis, strains and injury.
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- X-ray: AP and lateral of MCP/
- PIP/ DIP joints
- If suspected inflammatory Arthritis:
- FBC
- Uric
- U&E
- CRP
- ESR
- Rh factor
- Not responding to conservative treatment
- If inflammatory cause suspected, refer via Early inflammatory Arthritis pathway:
- Suspected inflammatory arthritis first episode and symptoms are more than 10 days and not responding to primary care
Finger pain - strain / injury
Affected Area
- Pain and/ Stiffness of MCP/ PIP/ DIP joints.
- Commonly caused by OA but can also be caused by inflammatory arthritis, strains and injury.
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- X-ray: AP and lateral of MCP/ PIP/ DIP joints
- If suspected inflammatory Arthritis:
- FBC
- Uric
- U&E
- CRP
- ESR
- Rh factor
- Not responding to conservative treatment
- If inflammatory cause suspected, refer via Early inflammatory Arthritis pathway:
- Suspected inflammatory arthritis first episode and symptoms are more than 10 days and not responding to primary care
Wrist pain
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Ganglion
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Carpal Tunnel
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De Quervain’s Tendonitis
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Dupuytren’s Disease
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Possible Rheumatoid Arthritis
