Approach
- Expose hands and forearms
- Place on white pillow or blanket with palm upwards
- Inspection
- DIPJ swollen (Heberden's nodes)
- Bouchard's nodes (PIPJ)
- "Square hand" appearance (carpo-metacarpal joint involvement of the thumb)
- Palpation
- Active movement
- Passive movement
- Move
- Active and passive movements of affected joints to define degree of reduction of movement
- Functional assessment: unbuttoning shirt
Completion
- Examine the other joints for arthritis
Treatment options for osteoarthritis of the hands
- Non-sugical
- Physiotherapy
- Pain relief
- Surgical
- Joint arthrodesis
- Arthroplasty - swanson silicone trapezium implant