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Arthritis of the Wrist, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

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Arthritis of the Wrist, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

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This book describes Wrist Arthritis, Diagnosis and Treatment and Related Diseases
Arthritis of the Wrist involves inflammation of one or more of the joints.
While the severity of symptoms linked to arthritis can differ, most arthritis-related diseases are long lasting.
While there are many forms of arthritis, the 4 that most often affect the wrist are:
1. Osteoarthritis (OA): forms overtime as cartilage naturally wears down
2. Rheumatoid arthritis (RA): an autoimmune disease that causes the body to attack its own tissues
3. Posttraumatic arthritis (PA): happens after an injury to the wrist
4. Psoriatic arthritis: an inflammatory skin and joint disease
When healthy, the bones slide easily over each other during movement, defended by the smooth cartilage that covers the joint surfaces.
Arthritis damages the cartilage.
Because of general wear and tear or an inherited tendency or a structural abnormality in a joint such as a previous fracture (break) or operation, the inner lining of the joint becomes thinner and may wear away resulting in bone rubbing on bone.
This is not considerably painful but could cause enough pain for the patient to complain.
The joint attempts to protect itself by forming a little more new bone at the edges and producing more joint fluid.
These result in stiffness and swelling.
Pain is a frequent symptom of arthritis.
1. Stiffness
2. Weakness
3. Swelling wrist arthritis
4. Limited range of motion
5. Clicking, cracking on movement
The doctor will do a careful examination of the hand and wrist, looking for:
1. Reduced range of motion
2. Any areas of pain or tenderness
3. Joint instability
4. Swelling or other changes in appearance
During the examination, the doctor may also evaluate:
1. Finger and thumb mobility
2. Nerve function
The ranges of motion may be measured with an angular ruler called a goniometer.
Tests are X-rays, scans, blood tests and particularly in the hand electrical tests (known as EMGs).
X-rays of the wrist will assist the doctor differentiate between different forms of arthritis.
With rheumatoid and other forms of inflammatory arthritis, blood tests are important for an accurate diagnosis.
There is no cure for arthritis, but there are a number of treatments that may help decrease the frequency of the symptoms and relieve the pain and loss of function it can cause.
Non-surgical Treatment
1.Activity modification
Topical NSAIDs can be applied directly to the skin in the area of the joint.
If the patient has kidney insufficiency or gastrointestinal disorders, the doctor will not likely keep the patient on NSAIDs for a long time.
If the patient has severe acute flares from the arthritis, steroids may be given.
The steroidal drug called methylprednisolone may be given as an oral treatment with a tapering dosing schedule to help treat the pain.
5.Steroid injection into the affected joint
6.The medicines known as disease-modifying anti-rheumatic drugs (DMARDs) are planned to stop the immune system from attacking the joints.
Surgical Treatment
The purpose of surgery is to alleviate pain while preserving or improving hand function.
Normally, this is done by reducing or removing bone-on-bone contact.
The most dependable operation is a wrist fusion (arthrodesis).
The choice of the operation is based upon the extent of the disease, surgeon preference and most of all patient preference.
The surgical methods from simple to complex are:
1.Wrist arthroscopy and washout: 70% satisfied.
2.Wrist denervation: 70% satisfied.
3.Proximal row carpectomy: 80-85% satisfied.
4.Wrist replacement: Unknown
5.Wrist fusion: 85% satisfied.

Chapter 1 Wrist Arthritis

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