What is it?
The terminal joint of the finger is called the distal interphalangeal joint (DIPJ) (see diagram). Osteoarthritis often affects these joints, and can also affect the joint at the base of the thumb (Basal thumb arthritis).
Osteoarthritis is loss of the smooth cartilage surface covering the ends of the bones in the joints. The cartilage becomes thin and rough, and the bone ends can rub together. Osteoarthritis can develop at any age, but usually appears after the age of 45. It may run in families.
What are the symptoms?
• Loss of function
Many people notice small bony bumps on the back of the joint. These are osteophytes, which are bony swellings associated with an osteoarthritic joint. In the finger they are called Heberden's Nodes.
Many people with osteoarthritis of these joints have very little pain. Even though the joints may become lumpy and bent, the hands usually continue to work quite well.
What is the treatment?
Episodes of pain, redness and swelling frequently settle spontaneously over some weeks or months, and can be managed by avoiding painful activities (if possible), simple painkillers, anti-inflammatory gels or anti-inflammatory medication. Steroid injections are sometimes given.
Surgery can be used to fuse (stiffen permanently) a joint that is persistently painful, but the potential benefit needs to be balanced against the loss of movement. The joint is usually fused in a straight or slightly bent position.
There are various surgical techniques used to obtain fusion and your surgeon will explain the technique he or she plans to use for you. After the surgery you may need to wear a splint to support and protect the joint for several weeks.
Joint replacement using a flexible silastic hinge is now a possibility and your surgeon can advise you about its indications and potential complications.
All artwork:©Donald Sammut 2017