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Primates, including human beings, are separated from the rest of the animal kingdom by one important digit - the first digit, the thumb. Imagine trying to hold onto a needle, a pen, or a hammer without a thumb; nearly impossible. That is why when the thumb becomes painful and useless a person can lose a job, lose a hobby, and lose the ability to live independently. Three common conditions affect the thumb: arthritis , de Quervain's Tendonitis, and carpal tunnel syndrome . Unfortunately, these three conditions usually go hand-in-hand and attack the same thumb.
In order to understand the thumb, one must know about the most important joint which is at the base of the thumb and called the carpometacarpal joint (CMC joint). The first CMC joint is the only CMC joint that has full range of motion: abduction, adduction, flexion, extension, and rotation. This motion is what gives the thumb full function for grasping, holding, pinching, and squeezing. And out of all the motions of the thum...
Over time our understanding of diseases deepens and evolves, for the scientific community as well as the patient community. This is certainly true for rheumatic and arthritic diseases. Today, I’d like to introduce you to one type of arthritis which is not widely discussed in the patient community.
What is Jaccoud’s arthropathy?
In 1869, F.S. Jaccoud, a French clinician, described cases of arthritis in patients following frequent and severe attacks of rheumatic fever. This type of arthritis was also known as chronic post-rheumatic polyarthrosis. Joint deformities are primarily in the hands, characterized by muscle atrophy, severe ulnar deviation and flexion at the big knuckle (or metacarpal-phalangeal) joints. It resembles rheumatoid arthritis, but with less inflammation and serum tests negative for Rheumatoid Factor.
Since -itis refers to inflammation, and since Jaccoud’s does not involve chronic inflammation as does rheumatoid ar...
Q: How do most patients get referred to a rheumatologist in the first place? Kremer: Usually, it’s the pain that’s perceived to be arthritis pain. Sometimes it’s muscle pain. Other times it can just be a nagging pain from anywhere that the primary care provider cannot diagnose. It’s more helpful to be referred to a rheumatologist when there are other symptoms along with the pain, such as early joint swelling. Q: What does the rheumatologist do when they see a referred patient? Kremer: We’ll take a history. Do you have morning stiffness? Fatigue? How long has this been going on? Do you have any family history of these same symptoms? After history, you do a physical exam looking for impaired joint movement, which joints are swollen, warm to the touch, difficult to move. Q: When do you take lab tests? And which tests do you start with first? Kremer: It depends on where the initial history and exams lead you. You many test for Rheumatoid factor (...
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