Osteoarthritis (OA) refers to a process of degradation and degeneration of the cartilage lining a joint, and subsequent changes in the bone adjacent to that joint. The wrist joint is a complex joint made up of the radiocarpal joint (between the radius and the proximal row of carpal bones) and the midcarpal joint (between the proximal and distal rows of carpal bones). This complex joint often becomes arthritic as a result of a previous, often unrecognized injury, in which case we term this "secondary osteoarthritis". Examples of such injuries include:
The degeneration of the joint can occur within a few years of the index injury, so can even affect young patients in their 20’s or 30’s.
There are other specific joints within the wrist that more often become arthritic through gradual degeneration (“primary osteoarthritis”). Fortunately this is relatively uncommon. Examples include the scapho-trapezio-trapezoid (STT) joint, and the pisotriquetral joint.
OA of the wrist causes pain, particularly on use, sometimes with stiffness and reduction in grip strength. There may be a background of aching discomfort. The amount this will affect someone will depend to a great extent on his or her occupation – those with heavier manual jobs being more affected. Naturally some hobbies can also be affected, particularly sports.
The diagnosis can usually be confirmed by taking X-rays of the wrist. Rarely more specialized imaging techniques are required, such as MRI scans or SPECT scans.
Treatment of this condition usually progresses from less invasive to more invasive techniques, depending on the level of symptoms and the response of those symptoms to treatment: