Rhizarthrosis, also known as osteoarthritis of the base of the thumb, is a degenerative disease that manifests itself in the destruction of articular cartilage and changes in the surrounding tissues. This condition most often affects the carpometacarpal (CMC) joint of the thumb, which may be due to a violation of its support and movement mechanisms. The main clinical manifestations of rhizarthrosis are pain, limited mobility, morning stiffness and joint deformity. The disease can significantly affect the functionality of the hands and, as a result, the patient's quality of life, leading to difficulties in performing simple daily activities.
History of the disease and interesting historical facts
The history of rhizarthrosis research dates back to the 19th century, when doctors began recording cases of degenerative joint diseases. One of the first scientists to describe such changes was Vladimir Bekhterev, who raised issues of cartilaginous and bone pathologies in his works. Interestingly, various cultures paid attention to joint diseases and their treatment. For example, in Ancient Egypt, compresses from heat carriers were used, and in traditional Chinese medicine, Manchurian root was used to reduce pain. The development of science in the 20th century, as well as modern technologies such as magnetic resonance imaging, have significantly improved the diagnosis and understanding of this disease.
Epidemiology
Rhizarthrosis is characterized by high prevalence, especially among the elderly. According to the latest epidemiological study, the risk of developing rhizarthrosis in women over 50 years of age is about 30%, while in men this figure is lower. About 10% cases of the disease are registered among representatives of active age groups (30-50 years). It has also been established that rhizarthrosis is more often observed in people with axial loads on their hands, such as musicians or athletes.
Genetic predisposition to this disease
Genetic predisposition to rhizarthrosis may be due to the presence of certain mutations in genes responsible for the synthesis of collagen and other components of cartilage tissue. In particular, the COL2A1 and COL11A1 genes play an important role in the formation of joint tissue. One recent study found an association between polymorphism in the IL1B gene and an increased risk of osteoarthritis, indicating a possible inflammatory component in the pathogenesis of rhizarthrosis.
Risk factors for the development of this disease
There are many factors that contribute to the development of rhizarthrosis. These include:
- Age: incidence increases with age;
- Gender: Women are more susceptible to the disease;
- Genetic predisposition: presence of cases of the disease in the family history;
- Excessive physical exertion: heavy physical labor or professional stress on the hand;
- Joint injuries: previous injuries to the thumb or wrist;
- Excess weight: increased stress on joints;
- Inflammatory diseases: the presence of inflammatory processes in the body.
Diagnosis of this disease
Diagnosis of rhizarthrosis begins with a clinical examination and anamnesis. The main symptoms of the disease are:
- Pain in the area of the base of the big toe;
- Limited joint mobility;
- Morning stiffness;
- Crunching sound when moving;
- Swelling and inflammation.
Laboratory tests may include tests for inflammatory markers such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Radiographic examinations, such as x-rays, may show joint space narrowing, osteophytes, and other changes characteristic of osteoarthritis. In some cases, magnetic resonance imaging (MRI) may be needed to evaluate the soft tissues. The differential diagnosis includes ruling out other inflammatory and degenerative joint diseases.
Treatment
Treatment of rhizarthrosis should be comprehensive and individualized. General approaches include:
- Avoiding stress on the affected joint;
- Physiotherapy:
- Exercises to strengthen muscles;
- Mass - massage and manual therapy;
- Therapeutic blockades with corticosteroids;
- Ultrasound therapy.
- Pharmacological treatment including:
- NSAIDs. Non-steroidal anti-inflammatory drugs.
- Local anesthetics;
- Chondroprotectors for restoration of cartilage tissue.
- Surgical treatment may be required in cases of severe changes:
- Arthroscopy;
- Arthrodesis;
- Joint prosthetics.
- Alternative treatments such as acupuncture or local compresses may be recommended as adjuvant treatments.
List of medications used to treat this disease
The main medications used for the treatment of rhizarthrosis include:
- Ibuprofen;
- Naproxen;
- Diclofenac;
- Glucosamine and chondroitin;
- Corticosteroids (only under physician supervision);
- Local anesthetics for injection.
Disease monitoring
Monitoring of patients with rhizarthrosis involves regular control stages to assess the dynamics of the disease. The prognosis with adequate therapy can be favorable, but complications in the form of chronic pain, progression of joint deformation and functional limitations are possible. Repeated examinations are recommended to assess changes in the condition of the joint and adjust the treatment plan.
Age-related features of the disease
Rhizarthrosis may manifest itself differently depending on the patient's age group. In young people, the disease is more often associated with injuries or excessive loads, while in older people it is associated with degenerative changes. In older patients, the symptoms may be smoothed out, but the disease progresses much faster. It is also noted that in women, the clinical picture is more pronounced against the background of hormonal changes associated with menopause.
Questions and Answers
- What is rhizarthrosis? Rhizarthrosis is osteoarthritis of the base of the big toe, characterized by degeneration of the articular cartilage and limited mobility.
- What are the main symptoms of rhizarthrosis? The main symptoms include pain at the base of the big toe, morning stiffness, crunching and swelling of the joint.
- What risk factors contribute to the development of rhizarthrosis? Risk factors include age, gender, genetic predisposition and joint injury.
- How is rhizarthrosis diagnosed? Diagnosis includes questionnaires, clinical examination, radiography and, in some cases, MRI.
- How to organize treatment for rhizarthrosis? Treatment should be comprehensive and include physical exercise, drug therapy, and in severe cases, surgery.
