Thumb Basal Joint / Carpometacarpal Arthritis
See also:
Basal/Metacarpal Joint Arthritis
What is it?
The basal joint of the thumb (also called the CMC
or Carpo-metacarpal joint) is located at the base
of the thumb, adjacent to the wrist. It is a very
mobile joint, normally allowing a significant
amount of motion to help position the thumb. Many
types of arthritis can affect this joint, with
degenerative arthritis, or osteoarthritis, being
most common. Degenerative arthritis of the thumb
CMC joint is many times more common in women than
in men. This arthritis may also occur as the
result of an injury.
What are the symptoms?
Pain is usually the most prominent symptom. The
pain may be sharp (with activity) or aching in
nature. It is located at the base of the thumb,
but can radiate in several directions. It is often
noticed with grasping activities or simple turning
tasks, such as opening a lid, holding a key, or
buttoning clothing. Patients often relate that
they drop objects that they are holding or picking
up. Limited motion of the thumb can occur, and may
affect the ability to open the palm as well as
limit the movement in other thumb joints. Swelling
and bony deformity of the joint may be visible.
"Catching" and "clicking" may
be felt and even heard.
How is it diagnosed?
The diagnosis of basal joint arthritis is based
upon a carefully performed history and physical
examination with confirmation by X-rays, which
allow the arthritis to be staged as early or mild,
moderate, or severe.
What is the Non-Operative Treatment?
Symptoms may be reduced with anti-inflammatory
medication, splinting, and rest. A corticosteroid
injection may provide relief, but will not repair
the joint. Thumb splints are effective but poorly
tolerated due to restriction of thumb motion.
Therapists may be able to provide techniques and
aids to allow activities so that less stress is
applied to the thumb.
What is the Surgical Treatment?
Most patients can be managed non-operatively, but
surgical reconstruction (joint replacement or
thumb basal joint arthroplasty) is very effective
for pain relief, and restoration of strength and
motion. After surgery, the patient will be
required to wear a cast for approximately four
weeks, followed by several months of hand therapy.
Physician's Who Treat This Disease
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guide written by our health care reviewers. The health information written
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physician. It is not intended nor implied to be a substitute for
professional medical advice.
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