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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
  • 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.
  • 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.
  • 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