Basilar Thumb Arthritis Pathway Posted: 1/11/2023 ID: (C102124)

Basilar Thumb Arthritis in 67F

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CASE DESCRIPTION

AGE	67 / Female
CC	Right thumb CMC pain
HPI	A 67-year-old right-hand dominant female homemaker presents with a two-year history of right thumb CMC pain. The pain is worse with gripping and pinching. She has had multiple corticosteroid injections into the right thumb CMC joint in the past year with minimal improvement. She has tried anti-inflammatory medications and thumb spica bracing for the past three months, which have been only mildly helpful. She is currently limited in her daily activities as a result of this issue.
PMH	She has no significant past medical history and does not smoke or drink.
PE	Physical exam of the right arm shows a positive thumb CMC grind test, a negative Finkelstein maneuver, and full thumb ROM. Fingers are warm and well-perfused. Her sensation is intact to light touch in the median, ulnar, and radial nerve distributions. She has 5/5 strength in the abductor pollicis brevis, extensor pollicis longus, and intrinsic hand muscles.

AGE/GENDER:

67 / Female

CHIEF COMPLAINT:

Right thumb CMC pain

HISTORY OF PRESENT ILLNESS:

A 67-year-old right-hand dominant female homemaker presents with a two-year history of right thumb CMC pain. The pain is worse with gripping and pinching. She has had multiple corticosteroid injections into the right thumb CMC joint in the past year with minimal improvement. She has tried anti-inflammatory medications and thumb spica bracing for the past three months, which have been only mildly helpful. She is currently limited in her daily activities as a result of this issue.

PAST MEDICAL HISTORY:	She has no significant past medical history and does not smoke or drink.
PHYSICAL EXAM:	Physical exam of the right arm shows a positive thumb CMC grind test, a negative Finkelstein maneuver, and full thumb ROM. Fingers are warm and well-perfused. Her sensation is intact to light touch in the median, ulnar, and radial nerve distributions. She has 5/5 strength in the abductor pollicis brevis, extensor pollicis longus, and intrinsic hand muscles.
DIAGNOSIS:	Basilar Thumb Arthritis in 67F