Arthrosis-of-Hand-and-Wrist
It is an inflammation that affects the various elements that make up a joint (an area where 2 or more bones are located and allows movements to be performed).

It manifests with localized pain to the affected joint, is accompanied by decreased movement of the same joint and typically worsens with age.

The most common arthritis is arthrosis and rheumatoid arthritis. In arthrosis the cartilage, which is the lining of the bones in the joint areas and which allows them to slide to perform movement, suffers wear and even disappears. Rheumatoid arthritis is a disease in which the body itself attacks the inner lining of the joints.

Uric acid crystals (gout), infections, psoriasis, lupus, etc … can cause other types of arthritis.

Treatment depends on the type of arthritis and the goal is symptom relief and improved quality of life.

Symptoms

The affected joints have:

– ache

– stiffness with decreased total movement

– edema (swelling)

– redness

– heat

– joint deformity (in advanced cases)

Disease mechanism

The 2 most common causes of arthritis damage the joint differently.

Arthrosis: In this situation there is a wear of the cartilage, the lining present at the ends of the bones in the joint areas. This coating allows the bones not only to slide smoothly producing movement but also the distribution and dissipation of energy generated in higher intensity movements such as jumping, thus preventing injury. If this lining deteriorates, which occurs over the years or as a result of fractures involving bones in the joint areas, severe sprains or joint infections, the bone will rub against bone causing pain and decreased movement of the joint. joint involved.

Rheumatoid arthritis:  In this disease the body attacks the tissue lining the joints (it is called synovial membrane and is equivalent to paint on the wall of a room). This membrane then becomes inflamed, reddened and swollen. As membrane inflammation increases as the disease progresses, cartilage and bone are gradually destroyed.

Risk factors

Risk factors for arthritis are:

Family History:  Some types of arthritis have a family component, which means that if parents or siblings suffer from the disease, there is a higher risk than the general population of developing it.

Age:  The risk of developing most arthritis increases with age.

Gender:  Rheumatoid arthritis affects women more often, gout in turn affects men more.

Prior Joint Injuries:  Any joint that has suffered a fracture or severe sprain suffers from early wear and develops sooner or later into arthrosis.

Obesity:  Increased weight on a joint causes premature wear, especially in the joints that support it such as the knee, hips, ankles and spine, so obesity is directly related to arthritis.

Complications

The disability resulting from the disease depends on the joints involved and the severity of the disease. If it affects the joints of the hands and arms, daily activities will be difficult. If the joints that support the body weight are affected, complaints arise when walking and even while sitting.

Diagnosis

The diagnosis is made by observing the joints, looking for swelling, redness, heat and evaluating the movement. Medical evaluation can be completed with analyzes (of the blood or even fluid in the joint) and rx (where it is possible to identify cartilage loss, bone destruction and osteophyte formation, commonly referred to as “parrot’s beaks”). It may be necessary, not for diagnosis but for definition of the treatment plan, to perform computed tomography (CT), magnetic resonance or ultrasound.

Treatment

The goal of treatment is to relieve symptoms and improve function.

Medication: There are several medications available to control pain and inflammation. They can be used as definitive treatment if they meet the treatment goals by allowing the patient to do day-to-day activities without complaints or with only residual complaints.

Physical Therapy:  It can promote relief in some types of arthritis especially by decreasing the inflammatory process and promoting muscle strengthening. In the course of treatment splints may be used for joint rest.

Surgery:  If conservative treatment (medication and physical therapy) does not work, surgery is recommended. The surgical options are adapted to the present pathology and the patient and are:

– Articular washing: Usually performed with 2 to 4 small incisions that allow the placement of instruments inside the joint through which it is possible to wash the joint, remove free bodies (fragments of cartilage that have come loose) and inflammatory tissue. Option valid in the early stages of arthritis or as a way to postpone a more aggressive surgical procedure.

– Joint replacement (arthroplasty): In this method the damaged surfaces are removed and replaced with a prosthesis or spacer (artificial or constructed from a patient’s own tendon) to eliminate pain and pain. conserve movement.

– Joint fusion (arthrodesis): This technique promotes joint elimination by removing the extremity of both bones and establishing, by placing plates and / or screws, the union of the two bones. By eliminating joint movement the pains triggered by the movement disappear. Inevitably this technique eliminates the movement of the locked joint, while allowing the use of the hand and arm.