Dr. Steinmann describes how he diagnoses a patient with thumb arthritis.
There’s two relatively simple ways to diagnose it that don’t take a whole lot of time. One is an x-ray and the x-ray is positioned usually about two or three views of your thumb, very quick x-rays, and based on that you can see the loss of joint space and the bone on bone arthritis that occurs with this condition. That will confirm the diagnosis of arthritis, but the clinical exam is most important.
When you examine the patient you can feel that they are having pain at their joint. You can feel the grinding of that joint. Sometimes there’s a little bit of looseness with that joint also.
It’s important to emphasize that it’s a clinical diagnosis, not just based on x-rays. I have a lot of patients that have carpal tunnel, for example. When we get x-rays sometimes for carpal tunnel and I’ll turn to the patient and say, “How does your thumb feel? You have a very arthritic thumb.” “Sir, it feels fine.”
So there’s the difference between radiographic arthritis, which may not hurt. So it’s possible that you could have an arthritic thumb and it doesn’t hurt and that does not require treatment at all. It’s only a symptomatic painful thumb that actually we treat with medications or bracing or surgery.
About Dr. Steinmann, M.D.:
Dr. Scott P. Steinmann, M.D., is on orthopedic surgery at the Mayo Clinic Sports Medicine Center in Minnesota. Dr. Steinmann received his medical training from Cornell University Medical College in New York, completed his residency in orthopedics at New York Orthopedic Hospital and completed a fellowships focusing on the shoulder and hand surgery from Columbia-Presbyterian Medical Center and Mayo Graduate School of Medicine respectively.