Arthritis of the Wrist, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

By Kenneth Kee

This book describes Wrist Arthritis, Diagnosis and Treatment and Related Diseases
Arthritis of the Wrist involves inflammation of one or more of the joints.
While the severity of symptoms linked to arthritis can differ, most arthritis-related diseases are long lasting.
While there are many forms of arthritis, the 4 that most often affect the wrist are:
1. Osteoarthritis (OA): forms overtime as cartilage naturally wears down
2. Rheumatoid arthritis (RA): an autoimmune disease that causes the body to attack its own tissues
3. Posttraumatic arthritis (PA): happens after an injury to the wrist
4. Psoriatic arthritis: an inflammatory skin and joint disease
Causes:
When healthy, the bones slide easily over each other during movement, defended by the smooth cartilage that covers the joint surfaces.
Arthritis damages the cartilage.
Because of general wear and tear or an inherited tendency or a structural abnormality in a joint such as a previous fracture (break) or operation, the inner lining of the joint becomes thinner and may wear away resulting in bone rubbing on bone.
This is not considerably painful but could cause enough pain for the patient to complain.
The joint attempts to protect itself by forming a little more new bone at the edges and producing more joint fluid.
These result in stiffness and swelling.
Symptoms:
Pain is a frequent symptom of arthritis.
1. Stiffness
2. Weakness
3. Swelling wrist arthritis
4. Limited range of motion
5. Clicking, cracking on movement
The doctor will do a careful examination of the hand and wrist, looking for:
1. Reduced range of motion
2. Any areas of pain or tenderness
3. Joint instability
4. Swelling or other changes in appearance
During the examination, the doctor may also evaluate:
1. Finger and thumb mobility
2. Nerve function
Diagnosis
The ranges of motion may be measured with an angular ruler called a goniometer.
Tests are X-rays, scans, blood tests and particularly in the hand electrical tests (known as EMGs).
X-rays of the wrist will assist the doctor differentiate between different forms of arthritis.
With rheumatoid and other forms of inflammatory arthritis, blood tests are important for an accurate diagnosis.
Treatment
There is no cure for arthritis, but there are a number of treatments that may help decrease the frequency of the symptoms and relieve the pain and loss of function it can cause.
Non-surgical Treatment
1.Activity modification
2.Immobilization
3.Medicines
Topical NSAIDs can be applied directly to the skin in the area of the joint.
If the patient has kidney insufficiency or gastrointestinal disorders, the doctor will not likely keep the patient on NSAIDs for a long time.
If the patient has severe acute flares from the arthritis, steroids may be given.
The steroidal drug called methylprednisolone may be given as an oral treatment with a tapering dosing schedule to help treat the pain.
4.Exercise:
5.Steroid injection into the affected joint
6.The medicines known as disease-modifying anti-rheumatic drugs (DMARDs) are planned to stop the immune system from attacking the joints.
Surgical Treatment
The purpose of surgery is to alleviate pain while preserving or improving hand function.
Normally, this is done by reducing or removing bone-on-bone contact.
The most dependable operation is a wrist fusion (arthrodesis).
The choice of the operation is based upon the extent of the disease, surgeon preference and most of all patient preference.
The surgical methods from simple to complex are:
1.Wrist arthroscopy and washout: 70% satisfied.
2.Wrist denervation: 70% satisfied.
3.Proximal row carpectomy: 80-85% satisfied.
4.Wrist replacement: Unknown
5.Wrist fusion: 85% satisfied.

TABLE OF CONTENT
Introduction
Chapter 1 Wrist Arthritis
C

• Language: English
• Publisher: Kenneth Kee
• Release date: May 15, 2018
• ISBN: 9780463735022

Kenneth Kee

Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"

Book preview

Arthritis of the

Wrist,

A

Simple

Guide

To

The Condition,

Diagnosis,

Treatment

And

Related Conditions

By

Dr Kenneth Kee

M.B.,B.S. (Singapore)

Ph.D (Healthcare Administration)

Copyright Kenneth Kee 2018 Smashwords Edition

Published by Kenneth Kee at Smashwords.com

Dedication

This book is dedicated

To my wife Dorothy

And my children

Carolyn, Grace

And Kelvin

This book describes Wrist Arthritis, Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.

(What The patient Need to Treat Wrist Arthritis)

This eBook is licensed for your personal enjoyment only. This eBook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each reader.

If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.

Thank you for respecting the hard work of this author.

Introduction

I have been writing medical articles for my blog http://kennethkee.blogspot.com (A Simple Guide to Medical Disorder) for the benefit of my patients since 2007.

My purpose in writing these simple guides was for the health education of my patients.

Health Education was also my dissertation for my Ph.D (Healthcare Administration).

I then wrote an autobiolographical account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.com.

This autobiolographical account A Family Doctor’s Tale was combined with my early A Simple Guide to Medical Disorders into a new Wordpress Blog A Family Doctor’s Tale on http://kenkee481.wordpress.com.

From which many free articles from the blog was taken and put together into 800 eBooks.

Some people have complained that the simple guides are too simple.

For their information they are made simple in order to educate the patients.

The later books go into more details of medical disorders.

The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.

Since 2013, I have tried to improve my spelling and writing.

As I tried to bring the patient the latest information about a disorder or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.

Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.

I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.

I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.

I apologize if these repetitions are irritating to some readers.

Chapter 1

Wrist Arthritis

What is Wrist Arthritis?

Arthritis of the Wrist involves inflammation of one or more of the joints.

Pain and stiffness are frequent symptoms of arthritis, and when these happen in the wrist, simple daily activities can become more problematic.

The wrist is also the most useful of the joints being able to:

1. Carry things

2. Write or type

3. Wash hands and other things like dishes, clothes

4. Shake hands or communicate

5. Use tools like screwdriver, hammer

These are only a few functions of the wrist

There are many forms of arthritis, and most of these can involve the wrist.

While the severity of symptoms linked to arthritis can differ, most arthritis-related diseases are long lasting.

This indicates that they are chronic even permanent and can ultimately produce serious joint damage.

While there are many forms of arthritis, the four that most often affect the wrist are:

1. Osteoarthritis (OA): forms overtime as cartilage naturally wears down

2. Rheumatoid arthritis (RA): an autoimmune disease that causes the body to attack its own tissues

3. Posttraumatic arthritis (PA): happens after an injury to the wrist

4. Psoriatic arthritis: an inflammatory skin and joint disease

There are four forms of arthritis that can involve the wrist:

Osteoarthritis

Osteoarthritis can form due to normal wear-and-tear in the wrist, mostly in people who have a family history of arthritis.

It is a frequent disorder for many people after they reach middle age, though it may happen in younger people, too.

In osteoarthritis, the smooth, slippery articular cartilage that covers the ends of the bones slowly wears away over time.

Since the cartilage surface has little to no blood supply, it has little capability to repair 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.

Osteoarthritis in the wrist can also form from Kienbock's disease.

In Kienbock's disease, the blood supply to one of the carpal bones (the lunate) is interrupted, causing the bone to die and slowly collapse.

Over time, this collapse can result in changes and arthritis in the joints around the lunate.

Patients normally present in middle age and later (40years and onwards) with slowly rising stiffness/pain/deformity.

They may work together or one or other may predominate.

Occasionally the symptoms will happen quite rapidly after a sudden injury which may be quite mild but then transforms the joint over from being possibly symptomatic to being symptomatic.

The symptoms may be more causing marked disability due to restricted movement and pain both at night and in the day.

The most frequent symptom is stiffness with or without pain.

Rheumatoid Arthritis

Rheumatoid arthritis is a chronic disease that can involve multiple joints throughout the