Wrist osteoarthritis

What is wrist osteoarthritis?

In the wrist osteoarthritis there is a deterioration in the cartilage of at least one of the joints that compose the wrist. The wrist is composed of several joints that are named with the bones that interact in them.

There are different types of osteoarthritis of the wrist depending on their origin:

  1. Post-traumatic osteoarthritis of the wrist:
    • Radiocarpal arthrosis, sequelae of joint fractures of the distal radius.
    • Arthrosis following a fracture (pseudarthrosis) of the scaphoid called SNAC wrist
    • Arthrosis following a severe scapholosemilunar sprain, SLAC wrist
  2. Degenerative wrist osteoarthritis:
    • Ulnar lunate arthrosis in ulnar-carpal conflicts.
    • Peri-trapezius, scapho-trapezio-trapezoid (STT) and trapezio-metacarpal (rhizarthrosis) arthrosis
    • Floor-triquetral arthrosis presenting as chronic tendinitis of the wrist
    • Osteoarthritis resulting from Kienbock’s disease or aseptic necrosis.
  3. Rheumatoid arthrosis as a consequence of an evolutive arthrosis of the wrist:
    • Microcrystalline arthritis (SCAC wrist chondrocalcinosis, gout…).
    • Autoimmune arthritis: rheumatoid polyarthritis, systemic lupus, Jacou’s hand, psoriasis…

Prognosis of the disease

Like any type of osteoarthritis, osteoarthritis of the wrist is a chronic degenerative disease, i.e. there is no solution to eliminate it.

The treatment is focused on ending or alleviating the pain it presents and avoiding, as far as possible, that this pain increases again in the future.

Symptoms of osteoarthritis of the wrist

Wrist osteoarthritis manifests itself through pain, and in most cases progressive.

Wrist osteoarthritis is often accompanied by swelling of the affected area, but this is not always easily visible due to the small size of each wrist joint.

Other symptoms may include clicking with movement, restriction of wrist motion, and the presence of fluid in the contours of the joints that make up the wrist.

Medical tests for osteoarthritis of the wrist

When diagnosing osteoarthritis of the wrist, the specialist will review the patient’s medical history, then a clinical examination will be performed, which will be completed with radiographic analysis, which in all cases will include the performance of an arthroscan of the wrist (or arthro-MRI of the wrist). This is intended to determine the state of wear and tear of each joint and any associated ligament injuries.

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Wrist osteoarthritis, like all types of osteoarthritis, is directly related to age and cannot be avoided.

What are the causes of wrist osteoarthritis?

Wrist osteoarthritis occurs when there is a bad movement of the wrist that is repeated continuously changing the anatomy of the wrist.

Usually sprains, fractures or other injuries are the triggers for this change in the normal movements of a wrist so early detection of these movements can help to avoid this pathology.

Can it be prevented?

Osteoarthritis is directly related to age, so it is not possible to avoid it, although it is possible to delay its onset to a great extent by means of physical exercise and correct nutritional habits, among other preventive measures.

Treatments for wrist osteoarthritis

The main objective of treatment, whether medical or surgical, is to relieve wrist pain.

In the early stages of osteoarthritis of the wrist, the first medical treatment suggested is analgesic medication, long-acting corticosteroid infiltration and nocturnal rest orthosis.

In cases of more severe osteoarthritis the necessary treatment is wrist surgery.

There are different types of surgery for osteoarthritis of the wrist:

  • Denervation of the wrist in painful but mobile osteoarthritis.
  • Partial fusion (scapho-capitate arthrosis, arthrodesis 4 bone…) in partial and already stiff arthrosis.
  • Complete articular fusion (complete arthrosis) in complete wrist arthroses
  • Wrist prosthesis, total or partial (pyrocarbon, PLGA) In most of these wrist operations, arthroscopic sub-surgeries can be performed in order to reduce convalescence and make the operation much more precise, as well as to reduce the pain caused by a surgical intervention.

Which specialist treats it?

Traumatology specialists work in the prevention, diagnosis and treatment of diseases and injuries of the musculoskeletal system, such as osteoarthritis of the wrist. The purpose of the traumatologist is to surgically and orthopedically treat injuries or fractures of the bones, muscles, joints and ligaments.