tailieunhanh - Chẩn đoán Viêm khớp

Thứ đến viêm khớp ở khớp cơ bản của ngón tay cái đau ngón tay cái là một tình trạng phổ biến, đặc biệt là ở phụ nữ, và có thể được hoàn toàn vô hiệu hóa. Một chẩn đoán chính xác có thể dễ dàng thực hiện từ lịch sử, kiểm tra. Chụp X quang được sử dụng để giai đoạn mức độ nghiêm trọng của bệnh viêm khớp. | Basal Joint Arthritis of the Thumb O. Alton Barron MD Steven Z. Glickel MD and Richard G. Eaton MD Abstract Thumb pain secondary to arthritis at the basal joint of the thumb is a common condition especially in women and can be quite disabling. An accurate diagnosis can be readily made from the history and examination. Radiographs are used to stage the severity of the arthritis. Splinting is the mainstay of conservative care. Reconstructive procedures for each stage of the disease are aimed at restoring thumb motion and strength. Partial or complete trapeziectomy with tendon interposition and ligament reconstruction to stabilize the metacarpal base is used for advanced disease. Secondary metacarpophalangeal joint hyperextension deformity may need to be addressed. Surgery can reliably improve function and engender high patient satisfaction. J Am Acad Orthop Surg 2000 8 314-323 The basal joint is the osteoarticu-lar foundation from which the opposable human thumb is able to perform its myriad functions and movements. The unique anatomic configuration allows arcs of movement in three planes to position the thumb for axial loads. It is not surprising then that degenerative arthrosis of the basal joint articulation is common even when nearby joints remain unaffected. Radiographic evidence of basal joint degeneration will ultimately develop in approximately 1 in 4 women and 1 in 12 Even though many individuals with involved thumbs will remain essentially asymptomatic in those who are symptomatic the pain and dysfunction secondary to this problem are the common presenting complaints. Furthermore symptoms secondary to basal joint disease can be mistakenly attributed to other conditions such as carpal tunnel syndrome and de Quervain tenosynovitis. Basic Science Etiology Although instances of traumatic causation of basal joint arthritis of the thumb have been documented there is no longitudinal natural history study that has established a clear etiology for basal joint