Metacarpophalangeal Joint Arthritis

The metacarpophalangeal (MP or MCP) joints are large joints at the base of each finger. These complex hinge joints are important for both power grip and pinch activities.

Causes of Metacarpophalangeal Joint Arthritis

The MP joints are less often affected by arthritis than the smaller joints in the hand or the joints where the thumb joints the wrist (CMC).

Rheumatoid arthritis is the most common arthritic condition affecting the MP joints. When this condition develops, the joint lining (synovium) produces chemical factors that inflame and destroy the cartilage and soft tissue, such as ligaments and tendons. The joint surfaces are ultimately destroyed and the fingers drift into a characteristic ulnar-deviated position in which they point toward the little finger.

Less commonly, other conditions produce pain, deformity, and loss of motion. Previous injury may result in gradual loss of joint cartilage (post-traumatic arthritis) with progressive pain and stiffness. There are similar findings with osteoarthritis. Post-traumatic and osteoarthritis usually affect the thumb, index, and middle fingers, with the degree for deformity much less severe than in rheumatoid arthritis. Gout, psoriasis, and infection are less common causes of MP joint arthritis.

Diagnosis of Metacarpophalangeal Joint Arthritis

Rheumatoid arthritis causes longstanding pain, swelling, and deformity in multiple joints of both the upper and lower extremities. You may also notice a characteristic ulnar drift of your fingers with loss of motion, particularly extension (straightening) of the fingers.

In cases of osteoarthritis and post-traumatic arthritis, you may experience deep, aching joint pain that is worsened by grip and pinch activities. You may not have an obvious finger deformity, although swelling, especially in the spaces between large knuckles, may be present.

Dr. Patel can confirm the presence of MP arthritis thru x-rays. Special x-rays may also be necessary to look carefully at the metacarpal head may also be helpful, particularly in milder cases.

Treatment Options for MP Arthritis

There are various treatment options available, based on the degree of the joint destruction and the symptoms you are experiencing.

• Rheumatoid arthritis. Several medications are effective in combating the generalized inflammatory process. If medication fails to reduce symptoms or slow the destructive process, Dr. Patel may suggest other methods to offer temporary improvement.
• If your rheumatoid arthritis is at a stage without significant joint surface destruction, you may benefit from synovectormy. This involves the removal of active, inflamed lining tissue of the synovium joint in order to slow the destructive process and maintain cartilage.
• Post-traumatic arthritis. Anti-inflammatory medication, activity modification, and simple splints may provide symptom relief.

If you are experiencing progressive pain, deformity, and motion loss despite medical management, you may be a candidate for surgical treatment.

MP Joint Fusion or Replacement

Patients with severe joint destruction may benefit from either a joint fusion or joint replacement. Although thumb function improves after an MP joint fusion, the fingers may lose motion. Because of this, a joint replacement is usually preferred.

Salastic hinged implants offer reasonable pain relief and function, and have been particularly successful in older, more sedentary patients with low demand on the use of their hands. More recent types of implants that try to replicate the joint surface may offer benefits to younger individuals and patients with more active, vigorous lifestyles.

If you’re suffering from metacarpophalangeal joint arthritis, make an appointment with Atlanta Hand Specialist. Call (770) 333-7888 today. We have offices in Smyrna, Douglasville, and Marietta.