Osteoarthritis
Epidemiology
Usually after 50-60 years of age
Aetiology
Primary 90% of cases
Secondary
- AVN
- trauma
- instability
Pathology
Usually after 50-60 years of age
Primary 90% of cases
Secondary
- AVN
- trauma
- instability
1. Neck of 5th Metacarpal
2. Metacarpal Shaft
3. Metacarpal Head
4. Base of Metacarpal Fracture Dislocations
5. Base of Thumb Fractures / Bennett's / Rolanda
Non operative Management
Accept 45o angulation
- will have finger extensor lag, but will recover
Throwing injury
- seen in the throwing athlete
- repetitive microtrauma / valgus stress
- develop laxity
Initially
- lose velocity / accuracy
Develop medial pain
40% ulna nerve symptoms
Intrinsic
- inflammatory
- degenerative
Extrinsic
- traumatic
- spur
F > 40
Associations 60% of cases
- hypertension
- diabetes
- obese
- trauma
- prior surgery
- steroids
First generation (late 70s early 80s)
Results
Geographic
Least aggressive
- usually indicative of slow growing lesion
- usually seen in benign tumours
- may be myeloma / mets / OM
Narrow transition from normal to abnormal bone
- Margin of the lesion is well defined
- margin is easily separated from surrounding bone
- margin may be smooth / irregular, sclerotic / non sclerotic
Avascular necrosis & subsequent disintegration of lunate
50-75% history of trauma
Occasionally seen in sickle cell / steroid use
Trauma disrupting vascularity
- single incident with disruption of blood supply
Technique
- in plane of thorax
- oblique of GHJ
Grashey
- angle 45o lateral
- allows estimation of glenohumeral space
Heterogeneous group of diseases characterised by
- hyperuricaemia
- recurrent attacks of acute arthritis
Diagnosis confirmed by
- crystals of Monosodium Urate in synovial fluid
- tophi ("Porous stone") urate in soft tissues
- renal urate stones
Adult men