What are they?
Proliferative changes concerning bones, tendon sheath, tendons generated during the course of other diseases, e.g. rheumatoid arthritis, degenerative joint disease or following injuries.
The most frequent symptoms are pain and deformation of fingers or the hand. Initially pain may occur occasionally while resting and can increase when hands are used and become permanent causing degradation of the quality of life. There are very often wrist or finger edemas together with symptoms of an inflammatory condition (pain, edema, reddening, temperature above normal, restriction of mobility). Edemas can periodically increase or decrease. Initially, deformations are visible in the form of small joint swellings, finally to reach extensive deformation of the hand making its normal functioning impossible.
Examination and diagnosing of the disease
Diagnosing requires collecting data in an interview and examination of the Patient. Usually it is enough to make X-ray or USG images of both hands and wrists to make a correct diagnosis.
It is very often necessary to consider the necessity to make a magnetic resonance image MRI or computer tomography CT. Very often it is necessary to consult the patient with a rheumatologist.
The patient can undergo an invasive or non-invasive treatment. If the source of the degenerative changes is a systemic disease, e.g. rheumatoid arthritis (RA), special rheumatologic treatment is necessary to reduce the inflammatory condition and pain.
Non-invasive methods of treatment:
- Immobilization – orthotoses, in order to eliminate movement of the hand or part of it.
- Rehabilitation and physiotherapy can also be applied.
Invasive methods of treatment:
- Application of the so called “blockade” through administering steroid drugs
- Platelet-rich plasma / growth factors therapy, i.e. PRP
- Administration of agents improving “ lubrication” of a joint, e.g. hyaluronic acid
- Performing surgery
A surgery may include removal of the inflammatory conditions of structures – tenosynovium, removal of the inflammatory liquid, removal of the inflammatory granulation, implantation of an artificial joint, stiffening of a joint by operation. The method of treatment must be precisely explained to the Patient before starting a treatment.
It is necessary to continue general treatment. It is absolutely necessary to abide by the recommendations of the surgeon after the surgery as well as to continue the started rehabilitation. After the surgery, different types of immobilization – stiff or soft – are often applied.
Not all the degenerative conditions can be removed. You must accept the disease and minimize pain and dysfunction of the hand, which pain can result in.
Objective of the treatment: improving quality of the Patient