Rhizoarthrosis - Rhizarthrosis

, or rhizarthrosis, is the "arthrosis of the trapezius-metacarpal joint which resides at the base of the thumb and on which the opposition movement of the first finger of the hand to the other fingers depends.

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Characterized by a "chronic type of inflammation, rhizoarthrosis is more often the result of a combination of factors (advanced age, female sex, genetics, etc.), rather than a single cause.
The presence of rhizoarthrosis is generally associated with symptoms such as: pain and tenderness at the base of the thumb, joint stiffness and difficulty in movement.
Diagnosed through an "analysis of the symptomatological picture and an X-ray examination, rhizoarthrosis is a condition that can only be treated in terms of symptoms, as there is no specific cure.
Among the symptomatic treatments of rhizoarthrosis, there are conservative therapies and surgical therapies.

Review of "arthrosis

Like any joint in the human body, mobile joints also put two or more bones into mutual contact; unlike other human joints, however, these irreplaceable anatomical elements possess, on the interacting portions of the bones, a particular layer of cartilage, which has a protective and anti-friction function; in fact, without this cartilage - properly called articular cartilage - the portions of the bones involved in the joints in question would rub against each other, damaging, deforming and causing pain.
Within the framework described above, arthrosis takes on the role of a chronic disease of the mobile joints which, causing the progressive degeneration and gradual thinning of the articular cartilage, involves the inflammation of the bony portions underlying the aforementioned articular cartilage.
Osteoarthritis, or osteoarthritis, is the most common type of arthritis; arthritis is the medical term for inflammatory processes based in the joints.

and the first metacarpus, an articulation that allows the human being to perform, with the first finger of the hand, the movements of flexion, extension and opposition to the other fingers.

A little anatomy to better understand rhizoarthrosis ...

What is the carpus? Representing the very first part of the skeleton of the hand, it is the group of 8 bones (including the trapezius) that takes part in the wrist joint and the carpometacarpal joints (NB: the trapezium-metacarpal joint involved in rhizoarthrosis is one of these).
What is the first metacarpus? It is the bone of the hand between the trapezius carpal bone and the proximal phalanx of the thumb; the proximal phalanx of the thumb is the first of the two bones that make up the thumb.

Rhizoarthrosis is the most common arthrosis of the hands

Statistics in hand, rhizoarthrosis is the most common form of arthrosis in the hands.
In the "list of the various types of arthrosis of the hands, therefore, rhizoarthrosis precedes the" arthrosis of the wrist, the "arthrosis of the proximal interphalangeal joints (ie the joints between the proximal and intermediate phalanges) and the" arthrosis of the distal interphalangeal joints (ie the articulation between the intermediate and distal phalanges).

of rhizoarthrosis are the result of the damaging rubbing of the trapezius on the first metacarpus, after which in both these bones the articular cartilage has been the victim of degeneration and thinning.

But what causes articular cartilage degeneration?

According to experts, the degeneration of the articular cartilage on which rhizoarthrosis depends does not depend on a precise cause, but on a combination of causes or, as it would be more correct to say in these cases, a combination of factors.
The factors in question include:

Older age. Rhizoarthrosis can affect people of all ages, however it is a fact that very rarely affects young people and young adults, while it is very common among individuals over the age of 45.
Membership in the female sex. Statistics show that rhizoarthrosis and, more generally, arthrosis of the hands are more common in the female population than in the male one.
Furthermore, from the same statistics, it emerges that rhizoarthrosis has a predilection for postmenopausal women, who are over 55 years old.
A past history of thumb joint injuries. The idea that injuries to the thumb joints favor the onset of rhizoarthrosis is the result of the large number of patients with a history of traumatic events affecting the first finger of the hand.
Injuries to the thumb joints are typical of those who perform manual work and play sports such as rugby, volleyball, basketball, etc., in which the use of the hands is essential to practice.

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The genetic predisposition to arthrosis. Some human genetic diseases are closely related to the degenerative phenomena that affect the articular cartilage and cause arthrosis.
The family predisposition to arthrosis. Experts have observed that those suffering from rhizoarthrosis or other forms of arthrosis (eg gonarthrosis) very often belong to families, in which the same chronic joint disease recurs.
Obesity. According to some studies, fat cells produce a substance which, if present in large quantities as in obese people, is harmful to mobile joints, in particular to their articular cartilage.

Epidemiology

In the paucity of information relating to the incidence and diffusion of rhizoarthrosis, the data according to which the aforementioned joint inflammation is present in at least 20-25% of menopausal women certainly deserves a mention.

of rhizoarthrosis are:

Pain at the base of the thumb
Swelling at the base of the thumb
Sense of soreness at the base of the thumb. The patient feels this sensation more if he presses at the base of the thumb;
Abnormal sounds when thumb movement
Difficulty in performing simple manual gestures such as opening a jar, opening a lock, etc .;
Sense of stiffness in the trapeziometacarpal joint, combined with considerable difficulty in performing the thumb extension movement.

A few more details on the pain of Rhizoarthrosis

Pain at the base of the thumb is the main symptom of rhizoarthrosis.
At the beginning of the inflammatory process, it is present only when the patient performs particular movements with the thumb or when the patient is engaged in manual activities that require a certain dexterity. In the later stages of inflammation, on the other hand, it becomes, at first, a slight sensation of a transitory nature (ie "comes and goes") and, subsequently, a constant presence of varying intensity.
At the height of rhizoarthrosis - that is when the inflammation is severe and the articular cartilage is now highly deteriorated - the pain in question is very intense and present at every moment of the day, so much so that it is a strong disturbance to sleep at night.

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Unilateral or bilateral rhizoarthrosis

Rhizoarthrosis can be unilateral or bilateral, that is, it can affect only one of the two thumbs (unilateral) or both (bilateral).
Generally, it begins as a unilateral condition and becomes bilateral only at later times.

When to see a doctor?

The presence in a person at risk of rhizoarthrosis of a suspicious pain at the base of the thumb, combined with stiffness and joint stiffness, is an excellent reason to contact the treating doctor, in order to investigate the situation.
Prompt use of a treatment for rhizoarthrosis is important to slow down the degenerative process of the articular cartilage and postpone complications.

Complications of Rhizoarthrosis

The long-term consequences of rhizoarthrosis basically consist of:

A Z-shaped deformation of the thumb;
A reduction in muscle volume (muscle atrophy) of the so-called thenar eminence. The eminence thenar is the grouping of 3 muscles located on the part of the palm of the hand, exactly at the base of the thumb.

Did you know that ...

The muscles of the thenar eminence contribute, together with the trapezius-metacarpal joint, to the movements of flexion and opposition-to-the-other-fingers of the thumb.

etc.

X-rays, that is the radiological examination that serves to confirm the degeneration and thinning of the articular cartilage.

Generally, a doctor expert in diseases such as rhizoarthritis can diagnose the latter already after the first 3 steps of the procedure indicated above.

at the base of the thumb at least 4-5 times a day. Ice packs have incredible anti-inflammatory power. Each pack must have a minimum duration of 15 minutes and must not exceed 20 minutes;

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The administration of non-steroidal anti-inflammatory drugs (NSAIDs). Among the NSAIDs, the most prescribed in case of rhizoarthrosis are aspirin and ibuprofen;
The use of special braces during the night. It seems that the constant use of braces makes the painful sensation of the day less intense (especially the pain present immediately after waking up);
The application, on the skin of the thumb, of creams containing capsaicin. Several scientific studies have shown that capsaicin has an effective analgesic and anti-inflammatory power in the presence of arthrosis of the hands;
The administration, through direct injections into the painful joints, of corticosteroids. Corticosteroids are powerful anti-inflammatory drugs, whose prolonged use could lead to sometimes unpleasant side effects. For this reason, doctors only prescribe them when NSAIDs have been found to be ineffective and pain continues to be a persistent presence of significant intensity;
Physiotherapy for stretching and strengthening the muscles and ligaments of the hands, in general, and of the thumb, in particular.

SURGICAL TREATMENT

Entrusted to an orthopedic specialist in the treatment of hand pathologies, the surgical therapy of rhizoarthritis includes various types of intervention, including:

The reconstruction of the damaged joint or joints, with the insertion of prostheses. The intervention of reconstruction of a joint is called arthroplasty;
The fusion or realignment of the bone and joint portions affected by inflammatory processes (trapezius and first metacarpus). The fusion operation is an example of arthrodesis, while the realignment operation is an example of osteotomy;
The removal of part of the trapezius carpal bone by arthroscopy. This surgery is known as arthroscopic trapeziectomy;
The removal of the trapezius carpal bone, combined with the reconstruction of the ligaments. This procedure is called trapeziectomy with ligamentoplasty.

In the presence of rhizoarthrosis, orthopedists choose the type of surgery to be adopted based on factors such as: age of the patient, general state of health of the patient, severity of symptoms and will of the patient.

Importance of nutrition in Rhizoarthrosis

According to the "Arthritis Foundation (Foundation for Arthritis) of Atlanta (USA), a healthy diet, which contains a large variety of fruits, fresh vegetables, whole grains and lean meats, would help reduce the inflammatory state characterizing rhizoarthrosis (and in general all the various forms of arthrosis in the hands).
Among the foods most recommended by experts are: red grapes, purple grapes, red onion, red apples, berries, broccoli, green leafy vegetables, tomatoes, cherries, plums and citrus fruits.