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Osteoarthritis of the Hand/Thumb
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Osteoarthritis of the Hand/Thumb
Last updated 14th December 2022
Signs/Symptoms
- More common over age of 50
- May have firm, knobbly swellings at the finger joints (Heberden’s and Bouchard’s nodes)
- Osteoarthritis can be diagnosed clinically without investigations if a person:
- is 45 or over and
- has activity-related joint pain and
- morning stiffness that lasts no longer than 30 minutes.
Advice in Primary Care
- Long term condition; important to continue to maintain movement and strength without putting undue pressure through joints
- Activity modification i.e. taking short breaks during activities.
- Hand/ wrist ROM i.e. making full fist, stretching hands and thumb to finger opposition.
- Use of heat (when hands stiff/ache) and ice (when hand swollen/hot)
Actions in Primary Care
- Refer to NICE Clinical Guideline 177: Osteoarthritis: care and management. 2014
- Print out the following patient information leaflets
- If initial conservative advice fails to settle symptoms consider steroid injection by appropriately trained Healthcare practitioner. If symptoms persist local injections can be repeated 3 times per year. If this skill is not available in surgery refer into OT Hand clinic.
Referral to Secondary Care
- If problems persist despite primary care management REFER VIA SCI GATEWAY TO OCCUPATIONAL THERAPY HAND CLINIC and INCLUDE FOLLWING IN REFERRAL:
- Duration of self management
- Duration of symptoms
- History of trauma
- Symptoms unmanageable/impacting greatly on function
- Not responding to steroid injections
- Boggy, hot swelling; REFER DIRECT TO RHEUMATOLOGY. If boggy swelling of any hand joints, there may be an inflammatory arthritis, so please refer direct to Rheumatology describing the affected joints, onset and duration of symptoms. Suspicion of inflammatory joint disease. Raised inflammatory markers.
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