Erosive osteoarthritis typically affects hands
DEAR DOCTOR: What can you tell me about erosive osteoarthritis? I have it mainly in my hands and feet.
DEAR READER:
The most common form of arthritis, known simply as osteoarthritis, develops slowly over time due to complex changes in cartilage, bone and joint linings. Formerly known as “wear and tear” arthritis, osteoarthritis has no inflammatory component and typically occurs in multiple joints throughout the body. Erosive osteoarthritis, on the other hand, is an inflammatory form of the disease that occurs primarily in the hands and, sometimes, in the feet.
In the hands, erosive osteoarthritis develops earlier in life than does typical osteoarthritis, usually between the ages of 40 and 50. It’s most commonly diagnosed in women (rarely men) at the time of menopause, suggesting that loss of estrogen is a factor.
Unlike typical osteoarthritis, erosive osteoarthritis has a sudden and aggressive onset. The hand joints become warm, red, swollen and
tender, making it difficult to move the fingers. With this degree of inflammation, the disease can look much like rheumatoid arthritis, but unlike rheumatoid arthritis, erosive osteoarthritis involves the joints at the end of the fingers. Bony swellings develop upon these joints, creating what appears to be nodules. The joints lose their structure so much that the finger bones move laterally in opposite directions, making the fingers look wavy instead of straight. The inflammation can cause cartilage and bone in the joint to erode, giving the disease its name.
As for treatment, decreasing inflammation is the first place to start. This can be done with topical anti-inflammatories or oral anti-inflammatories. Drugs used for rheumatoid arthritis also can ease the inflammation and erosion. For severe cases, injecting steroids directly into the finger joints can decrease deformities. Also, physical therapy can improve finger mobility and reduce the likelihood that the fingers will become excessively crooked.