Orthopedics:
Conditions

Arthritis is a condition that involves the breakdown of the protective cartilage around the joints, which results in pain, stiffness, and inflammation.

Osteoarthritis of the Hand/Wrist

Osteoarthritis is a degenerative joint disease in which the cushioning cartilage that covers the bone surfaces at the joints begins to wear out. Stiffness, swelling, and pain are symptoms common to all forms of arthritis in the hand and wrist. Grip and pinch strength may be diminished, causing difficulty with activities such as opening jars or turning keys.

Treatment Options for Osteoarthritis of the Hand/Wrist

Treatment is designed to relieve pain and restore function. Anti-inflammatory medication may help in relieving pain. Heat and cold modalities may also be of help. It is important to maintain motion in the fingers and use the hand as productively as possible. A cortisone injection can often provide relief of symptoms but does not cure arthritis. Surgery is usually not advised unless these more conservative treatments fail.

Surgery is indicated when the patient either has too much pain or too little function. The goal is to restore as much function as possible and to eliminate the pain or reduce it to a tolerable level. There are two surgical treatment options available for treating osteoarthritis of the hand and/or wrist. Our hand surgeons at Emory will help you decide which type of surgery is the most appropriate for you. 

Osteoarthritis of the Elbow

Osteoarthritis of the elbow occurs when the cartilage surface of the elbow is damaged or becomes worn. Osteoarthritis is caused by our bones degenerating as we age due to simple wear and tear, but may also be caused by previous injuries such as elbow dislocations or fractures. The most common symptoms are pain and loss of motion in the elbow. Patients usually report a "grating" or "locking" sensation in the elbow.

Treatment is designed to relieve pain and restore function. Conservative treatment includes medications to reduce or alleviate pain, physical therapy, and activity modification. A cortisone injection can often provide relief of symptoms but does not cure arthritis. Surgery is usually not advised unless these more conservative treatments fail.

Surgical Treatment for Osteoarthritis of the Elbow

Surgery is indicated when the patient either has too much pain or too little function. If the wear or damage is limited, arthroscopy can offer a minimally invasive surgical treatment. It may be an option for patients with earlier stages of arthritis. If the joint surface has worn away completely, it is unlikely that anything other than a joint replacement would bring about relief. Our hand surgeons at Emory will help you decide which type of surgery is the most appropriate for you.

Rheumatoid Arthritis of the Hand/Wrist

Rheumatoid arthritis of the hand is most common in the wrist and knuckles. Often the joints feel hot and look red. The disease is symmetric, thus what occurs on one hand usually occurs on the other.

Symptoms of Rheumatoid Arthritis of the Hand/Wrist

• Sudden inability to straighten or bend a finger
• Numbness and tingling in the hand
• May hear a squeaky sound as they move their hands and fingers
• May feel a snap or locking sensation in the hand and fingers
• Deformity in which the middle finger joint becomes bent (Boutonniere deformity)
• Deformity where the end of the finger is bent and the middle joint over extends (Swan-neck deformity)

Rheumatoid Arthritis of the Hand/Wrist Treatment Options

There is no cure for rheumatoid arthritis, but medications are available that slow the progression of the disease. Optimal care involves a team approach among the patient, physicians, and therapists. The care of the rheumatoid patient requires not only a hand surgeon but also a hand therapist, a rheumatologist, and the patient’s primary care physician. The rheumatologist is often the physician that monitors and decides the specific type of medicine that is felt to be the most effective for the patient’s stage in the disease process.

Rheumatoid arthritis can be a progressive disease. In certain cases, preventive surgery may be recommended including removing nodules, decreasing pressure on joints and tendons by removing inflamed tissue, or removing bone spurs that may rub on tendons or ligaments. Our hand surgeons at Emory can help you decide on the most appropriate treatment for you.