Consultant – Gavin Brigstocke

What is Finger Arthritis?
Osteoarthritis is the loss of the smooth cartilage surfaces lining the ends of bones in the joints. In the fingers this is typically seen at the terminal joint called the distal interphalangeal joint (DIPJ) and less frequently at either the middle joint called the proximal interphalangeal joint (PIPJ) or the most proximal joint called the metacarpo-phalangeal joint (MCPJ). Arthritis will present with a combination of pain, swelling, deformity and loss of motion of the affected joint.

What treatments are available?
Many people have deformed arthritic finger joints but experience very little pain and maintain good hand function. With this scenario very little treatment is required. Should the joints become painful a range of non-operative and operative interventions may be appropriate. Non-operative measures include activity modification, painkillers, anti-inflammatory medication and targeted steroid injections into the arthritic joints. Surgery may be employed to either fuse or replace the joint.

What are the outcomes?
Joint fusion is a reliable pain-relieving procedure, however the potential benefit does come at the cost of permanently stiffening the joint. Joint replacement with either a flexible silastic hinge joint or pyrocarbon prosthesis may provide reliable pain relief and preserve motion. Joint replacement has well documented complications and the risks and benefits will be discussed with the patient prior to contemplating surgery.

Further information:
https://www.bssh.ac.uk/patients/conditions/23/terminal_finger_joint_arthritis