Arthritis of the Wrist

Arthritis affects millions of people in the United States. Simply defined, arthritis is inflammation of one or more of your joints. A joint is where the ends of bones meet. Inflammation causes swelling, pain, and stiffness in the joint.

A significant number of people have arthritis in their wrists and hands, which makes it difficult for them to do daily activities.

Description

Although there are hundreds of kinds of arthritis, most wrist pain is caused by just two types: osteoarthritis and rheumatoid arthritis.

Osteoarthritis
Osteoarthritis (OA) is a progressive condition that destroys the smooth articular cartilage covering the ends of bones. Healthy joints move easily because of articular cartilage. Osteoarthritis causes this cartilage to wear away. When the bare bones rub against each other, it results in pain, stiffness, and weakness.

(Left) Articular cartilage protects the ends of bones where joints meet. (Right) In this x-ray of a wrist with osteoarthritis, the cartilage is destroyed and the healthy space between bones is narrowed (arrow).
(Left) Reproduced from J Bernstein, ed: Musculoskeletal Medicine. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2003. (Right) Reproduced from JF Sarwark, ed: Essentials of Musculoskeletal Care, ed 4. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2010.

Rheumatoid Arthritis
Rheumatoid arthritis (RA) is a chronic disease that attacks multiple joints throughout the body. Rheumatoid arthritis often starts in smaller joints, like those found in the hand and wrist. It is symmetrical, meaning that it usually affects the same joint on both sides of the body.

Rheumatoid arthritis is an autoimmune disease. This means that the immune system attacks its own tissues. In RA, the defenses that protect the body from infection instead damage normal tissue (such as cartilage and ligaments) and soften bone.

RA often affects the joint between the two bones of the forearm, the radius and ulna. It can soften and erode the ulna which can cause tearing of the tendons that straighten your fingers. This can result in joint deformity, such as bent wrists and gnarled fingers.

Cause

Osteoarthritis can develop due to normal "wear-and-tear" in the wrist, particularly in people who have a family history of arthritis. It may also develop as a result of a traumatic injury, such as a broken wrist bone or a wrist sprain.

Osteoarthritis of the wrist can also develop from Kienböck's disease. In Kienböck's disease, the blood supply to one of the small bones of the hand near the wrist (the lunate) is interrupted. If the blood supply to a bone stops, the bone can die. Over time, this can lead to osteoarthritis.

The exact cause of RA is not known. There may be a genetic reason — some people may be more likely to develop the disease because of family heredity. However, doctors suspect that it takes a chemical or environmental "trigger" to activate the disease in people who genetically inherit RA.

Symptoms

OA of the wrist joint causes swelling, pain, limited motion, and weakness. These symptoms are usually limited to the wrist joint itself.

RA of the wrist joint also causes swelling, pain, limited motion, and weakness. However, in contrast to OA, wrist symptoms will usually be accompanied by pain, swelling and stiffness in the knuckle joints of the hand.

Contact Parkland's hand specialists to receive comprehensive evaluation and management for hand and wrist problems.