Osteoarthritis can develop due to normal “wear-and-tear” in the wrist, particularly in people who have a family history of arthritis. It is a common problem for many people after they reach middle age, though it may occur in younger people, too.
In osteoarthritis, the smooth, slippery articular cartilage that covers the ends of the bones gradually wears away over time. Because the cartilage surface has little to no blood supply, it has little ability to heal or regenerate when it becomes injured or worn down.
As the cartilage wears away, it becomes frayed and rough, and the protective space between the bones decreases. This can result in bone rubbing on bone and lead to pain and stiffness in the joint.
(Left) This x-ray of a healthy wrist shows normal joint space. (Right) In this wrist with osteoarthritis, the cartilage is worn and the healthy space between bones is narrowed.
Osteoarthritis in the wrist can also develop from Kienböck’s disease. In Kienböck’s disease, the blood supply to one of the carpal bones—the lunate—is disrupted, causing the bone to die and slowly collapse. Over time, this collapse can lead to changes and arthritis in the joints around the lunate.
Not all patients with arthritis will experience symptoms. When they do occur, the severity varies greatly from patient to patient. For some patients, the symptoms are not constant—but may come and go depending on their level of activity and other factors.
Symptoms of arthritis may include:
- Reduced range of motion or stiffness
- Weakness in the joint
Your doctor will talk with you about your overall health and medical history and ask you to describe your symptoms. He or she will perform a careful examination of your hand and wrist, looking for:
- Reduced range of motion
- Any areas of pain or tenderness
- Joint instability
- Swelling or other changes in appearance
During the examination, your doctor may also evaluate:
- Finger and thumb mobility—To determine how well your tendons and joints are functioning
- Nerve function—To determine if you have another condition that may be affecting your wrist, such as carpal tunnel syndrome (nerve compression)
X-rays. X-rays provide detailed images of dense structures, such as bone. X-rays of your wrist will help your doctor learn more about the exact location and severity of your arthritis. They can also help your doctor distinguish between various types of arthritis.
Blood tests. Your doctor may recommend blood tests to determine which type of arthritis you have. With rheumatoid and other types of inflammatory arthritis, blood tests are important for an accurate diagnosis. Osteoarthritis is not associated with blood abnormalities.