ABSTRACT
Arthritis of the wrist and first carpometacarpal (CMC) joint may be primary (idiopathic) or secondary to fractures of the scaphoid or distal radius, Bennett’s or Rolando fractures or scapholunate dissociation. Pain on stressing the wrist may indicate arthritis. Examination should be directed to the point of maximum tenderness. There is often a restricted range of movement with some crepitus. In the CMC joint, pain at the base of the thumb on pinch grip is characteristic. Axial rotation and grinding of the thumb are also painful. Radiographs usually reveal a loss of joint space, sclerosis and osteophyte formation. Cystic change may be present: intraosseous ganglia and rheumatoid arthritis should be considered as possible alternative causes.
