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A 55-year-old female patient presents with pain along the thumb ray and increasing deformity of her right hand. Key pinch causes her pain. The appearance of her hand is seen in Figure A. Range of motion of her thumb is seen in Figure B. What is the most likely cause of her deformity?
Type II hypoplastic thumb
Median nerve neuropathy
Lupus thumb deformity
Extensor tendon rupture
Osteoarthritis of the trapeziometacarpal joint
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A 60-year-old man has chronic pain at the base of this thumb and weakness on attempted thumb pinch. A radiograph is shown in Figure A. Which injection would likely reduce his pain and increase his function?
All of the above are equally effective
All of the above are detrimental
A 68-year-old female office assistant reports left thumb pain that has progressively worsened over the past 2 years. She is left hand dominant and reports difficulty with opening jars and holding a coffee cup. On examination of the left hand she has a positive thumb carpometacarpal grind test and has a fixed deformity at the thumb metacarpalphalangeal joint. Figure A demonstrates the left hand grasping an object and Figure B shows a radiograph of the left thumb. What is the most appropriate next step in treatment?
Carpometacarpal joint fusion and metacarpophalangeal joint volar capsulodesis
Carpometacarpal joint resection arthroplasty and metacarpophalangeal joint volar capsulodesis
Carpometacarpal joint resection arthroplasty and metacarpophalangeal joint fusion
Carpometacarpal joint resection arthroplasty and temporary metacarpophalangeal joint percutaneous pin fixation
Carpometacarpal joint fusion and metacarpophalangeal joint fusion
This video shows step-by-step technique for trapezium excision and LRTI (ligamen...
This video (without audio) portrays how to properly perform the CMC grind test f...
HPI - Patient is a healthy 66 year old right hand dominant female with several years of right greater than left pain at the base of her thumbs. She has used oral NSAIDs and topical voltaren gel, tried 3 corticosteroid injections in her right basal joint (helpful for a short time) and has used a thumb spica splint with minimal relief of her pain.
What is your preferred method to treat 1st CMC arthritis secondary to primary osteoarthritis surgically?