Saturday, September 14, 2013

Wrist Arthritis - What Could it Be?

Arthritis of the wrist may not sound like a big deal... until you need to open a door, type on your computer, or shake hands. Then you realize how much a role your wrist plays in these simple activities.

The wrist is like many other joints. It's enclosed in a synovial membrane. It consists of the ends of the radius and ulna- two long bones- that articulate with a row of eight carpal bones. The carpal bones in the wrist also articulate with the metacarpal bones of the hand. The entire wrist complex is stabilized by tendons and ligaments and encased in a synovial membrane.

When arthritis develops, the wrist complex is affected by inflammation of the synovial membrane as well as by any other problem that causes the cartilage that surrounds all the bones in the wrist to wear away.

While wrist pain may occur as the first sign of a problem, the inability to perform simple activities of daily living follows shortly.

The pain may be dull initially but then becomes sharper and more constant.

Grip strength diminishes. Inflammation progresses, then there may be pressure on the other structures that pass through the wrist such as the median nerve. This leads to carpal tunnel syndrome.

The treatment of wrist arthritis is dependent on the cause. Forms of arthritis that commonly affect the wrist include rheumatoid arthritis, psoriatic arthritis, gout, and pseudogout. When inflammatory forms of arthritis affect the wrist, there is wearing away of cartilage as well as damage to the supporting structures. Wearing away of the cartilage leads to misalignment and deformity as well as wrist dysfunction. Swelling and fluid accumulation may occur.

When wrist arthritis occurs, there is a benefit in that wrist involvement by arthritis generally is often a tip off to diagnosis. For instance, rheumatoid arthritis is one of the more common forms of arthritis that affect the wrist. By allowing an earlier diagnosis, early intervention can lead to remission.

Physical therapy and specific exercise may be beneficial as are splinting and anti-inflammatory medicines. Sometimes, injection with glucocorticoids may be necessary.

In advanced cases, surgery may be necessary. Surgical procedures include excision arthroplasty where the end of the ulna bone is removed. This often helps with some forms of arthritis since it allows more freedom of movement.

Joint fusion and joint replacement may be called for in extreme cases. Wrist replacement currently lasts about ten to fifteen years depending on the amount of activity.

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