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Hand OA Cheat Sheet (DRAFT) by

Management , Presentation

This is a draft cheat sheet. It is a work in progress and is not finished yet.

Hand OA

- DIP Joints most affected
- Can occur at the PIP, base of the thumb (CMC), index and middle MCP joints
- CMC degene­ration usually affects the non-do­minant hand


- Increases with age (between 50-60)
- Common in females
- Genetics
- Repetitive use
- Previous injury, lax, misaligned or deformed joint
- Labour /manuf­act­uring workers
- Obesity
- Secondary osteoa­rth­ritis - congen­tical, metabolic, endocrine, neurol­ogic, vascular disorders that cause OA - affects younger people


- DASH Questi­onnaire
- Symptoms provoked by activities and relieved by rest
- If bilateral and symmet­rical, swelling, morning stiffness >30 mins - consider inflam­matory arthro­pathy
- Tenderness of the affected joint
- Limited ROM and diminished grip (more advanced)
- Heberden's nodes present along joint lines
- Radial­/ulnar deviation of the affected digit - If digit subluxed towards palm, consider RA

ACR Criteria

- Hard tissue enlarg­ement in at least 2/10 selected joints (2nd + 3rd DIP + PIP, 1st CMC)
- >3 swollen joints
- Hard tissue enlarg­ement of >2 DIP joints or deformity on at least 2/10 selected joints


- Standard for OA
- Loss of joint space
- Subcho­ndral sclerosis
- Osteop­hytes


- Inflam­matory Arthro­pathy (RA, Gout, pseudo­gout, psoriatic arthritis, reactive arthritis, AS)
- Lyme Disease
- F#
- Infection
- Neoplasm
- Myofascial pain syndrome
- Tendin­opathy
- Neurop­athic arthro­pathy
- Peripheral neuropathy


- Soft tissue manipu­lation
- Nighttime splint for thumb
- Exercise
- ADL Advice
- Joint mobili­sation P/A glide + distra­ction
- Topical cream - capsaicin
- Aerobic, aquatic and resistance exercises
- If no reaction to conser­vative care, consider steroid injections and if signif­icant ROM and pain , consider surgical interv­ention