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Basilar Joint Arthritis
Services for Seniors’ medical conditions
Basal Joint arthritis is a condition that affects the base of the thumb where it connects to the wrist. This common condition can be very painful and inconvenient as it limits the use of the thumb. The thumb is a very important part of the hand, and most of the things we do on a day to day basis involve heavy use of the hands and thumb, including: gripping, pinching and holding.
Basal Joint arthritis can make it difficult to do simple things such as grip a mug and enjoy a cup of coffee, or something as simple as turning a small key and unlocking a car or house door.
Causes of Basilar Joint Arthritis
Basilar joint arthritis is a result of thinning of the cartilage between the thumb and the wrist. The joint then becomes inflamed leading to pain and swelling.
It is seen with all forms of arthritis including rheumatoid, osteoarthritis, and gout.
It can occur after fractures or injuries to the thumb although most cases have no clear causes. Like other forms of arthritis, it is more common in women than men.
Signs , symptoms and diagnosis of Basilar joint Arthritis
The diagnosis of basilar joint arthritis is made by conducting a history, examining the patient, and taking X-Rays. Patients with the condition often have a very similar history—they will usually complain of difficulty with pinching, gripping, and grasping activities and have trouble with zippers, opening jars, and turning keys.
The pain is generally activity-related and is often better with rest. There is often deformity and sometimes swelling at the base of the thumb. Furthermore, there will be a sensation of grinding with compression of the thumb joint. X-rays, as seen below, will usually reveal narrowing of the joint.
Population at risk of getting Basilar Joint arthritis
Basilar joint arthritis is much more common in women than men. This is most likely related to the fact that the ligaments around the basilar joint seem to be more lax in women.
With pinching and gripping activities, the joint is loaded with shear rather than compressive forces, which tend to result in the joint wearing more rapidly.
Individuals with a job or hobby that involves repetitive forceful gripping with the thumb could also be at greater risk of developing basilar joint arthritis.
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Comprehensive treatment of Basilar Joint Arthritis
The goal of treatment is to decrease pain in the basilar thumb joint. Often, symptomatic treatment is initially prescribed, including the use of splints, ice, moist heat, and over the counter (OTC) pain medicines (as allowed by the patient’s primary care provider). The use of chronic pain medicine is deferred to the primary care provider.
Another non-surgical option is a steroid injection into the joint. The steroid is an agent that decreases inflammation in the joint, and thus helps with pain.
Steroids can cause tissue breakdown, so there is a limit on the number of injections that can be given.
The primary goal of surgery for basilar thumb arthritis is pain relief. A common procedure performed for this problem is a Ligament Reconstruction Tendon Interposition arthroplasty (LRTI). In this procedure, a wrist bone called the Trapezium is removed and replaced with a tendon taken from the patient’s forearm.
This eliminates one bone from the arthritic joint, thus decreasing the cause of the pain. As described, a bone in the wrist is replaced by soft tissue, therefore a common side effect of this surgery is weakness in the thumb.
Again, this procedure is for pain control, generally reserved for cases that do not respond to other treatments. Other surgeries may be performed for Basilar Thumb Arthritis as well, depending on surgeon preference and experience.
