Ultrasound-Guided Cortisone Injections for Thumb Osteoarthritis

 

Introduction

Thumb osteoarthritis, often referred to as basal joint arthritis, is a common condition that primarily affects the carpometacarpal (CMC) joint at the base of the thumb. This condition can have a significant impact on daily life, as the thumb is essential for gripping, pinching, and performing fine motor tasks. When osteoarthritis develops in this joint, it can make even simple activities challenging.

At Joint Injections, our clinicians provide ultrasound-guided cortisone injections as part of the management options for thumb osteoarthritis. Using advanced imaging, these injections are delivered with precision, supporting a tailored approach to patient care. This blog explores thumb osteoarthritis in detail, covering its anatomy, pathology, symptoms, diagnosis, management options, and the role of ultrasound-guided cortisone injections.

Anatomy of the Thumb Joint

The thumb’s carpometacarpal (CMC) joint is a saddle-shaped joint where the first metacarpal bone meets the trapezium bone of the wrist. This joint allows a wide range of movement including flexion, extension, abduction, adduction, and opposition. Such versatility enables humans to perform gripping and pinching actions.

The CMC joint is stabilised by several ligaments and surrounded by cartilage that cushions and supports smooth movement. Due to its extensive mobility and the forces it endures during daily activities, this joint is particularly vulnerable to wear and tear, making it a common site for osteoarthritis.

Pathology of Thumb Osteoarthritis

Osteoarthritis is a degenerative condition characterised by the breakdown of cartilage, changes in the underlying bone, and inflammation of the joint lining. In the case of thumb osteoarthritis:

  • The cartilage protecting the trapezium and metacarpal bones gradually wears away.
  • Bone-on-bone contact may occur, causing discomfort and stiffness.
  • The joint may develop osteophytes (bone spurs), further reducing mobility.
  • Inflammation of the surrounding tissues can contribute to swelling and discomfort.

This process is typically progressive, with symptoms becoming more pronounced over time.

Causes and Risk Factors

Several factors contribute to the development of thumb osteoarthritis:

  • Ageing — natural wear and tear on the joint structures.
  • Gender — more common in women, particularly after menopause.
  • Repetitive use — occupations or activities involving frequent gripping or pinching.
  • Previous injury — fractures or sprains that affect joint alignment.
  • Genetic predisposition — some individuals naturally have looser ligaments or altered joint mechanics that increase susceptibility.

Symptoms

Thumb osteoarthritis typically presents with the following symptoms:

  • Pain at the base of the thumb, especially during gripping, pinching, or lifting objects.
  • Swelling and tenderness around the CMC joint.
  • Reduced range of motion, making it difficult to perform everyday tasks.
  • Weakness in grip strength.
  • A visible bump or deformity at the base of the thumb in advanced cases.

These symptoms often worsen with activity and may improve with rest.

Diagnosis

Diagnosis of thumb osteoarthritis usually involves a combination of clinical evaluation and imaging:

  • History and examination — clinicians assess the pattern of symptoms, functional difficulties, and any previous injuries.
  • Physical tests — such as the grind test, where the clinician gently rotates and compresses the thumb joint to reproduce discomfort.
  • Ultrasound — may be used to evaluate soft tissues, joint inflammation, and to guide injections accurately.

Management of Thumb Osteoarthritis

The management of thumb osteoarthritis is based on severity and functional impact. Options include conservative measures, injections, and surgery in advanced cases.

Conservative approaches may include:

  • Activity modification and ergonomic adaptations.
  • Use of thumb splints to support the joint during activity.
  • Exercises to maintain mobility and strengthen surrounding muscles.
  • Application of heat or cold for comfort.

Interventional options may include:

  • Cortisone injections to target inflammation within the joint.
  • Other injectable therapies, depending on clinical assessment.

Ultrasound-Guided Cortisone Injections

At Joint Injections, cortisone injections for thumb osteoarthritis are delivered under ultrasound guidance. This approach allows clinicians to:

  • Visualise the CMC joint in real time.
  • Deliver the cortisone precisely to the intended area.
  • Minimise risk by avoiding surrounding structures.

By using ultrasound guidance, injections are performed with accuracy and tailored to the individual’s anatomy.

Mechanism of Action of Cortisone

Cortisone belongs to the corticosteroid family of medications. Its mechanism of action includes:

  • Anti-inflammatory effect — reducing swelling in the joint lining.
  • Decreasing tissue irritation — by calming the inflammatory process.
  • Supporting joint function — through improved comfort and mobility.

By targeting inflammation within the joint, cortisone injections may support improved hand use and function.

Role of Joint Injections

At Joint Injections, our clinicians provide tailored treatments for musculoskeletal conditions such as thumb osteoarthritis. Key aspects of choosing our service include:

  • Expert clinicians experienced in musculoskeletal ultrasound.
  • Precision techniques using real-time imaging guidance.
  • Patient-focused approach ensuring that treatment is designed around individual needs.
  • Efficient outpatient procedures performed in a professional and supportive environment.

Conclusion

Thumb osteoarthritis is a common condition that can significantly affect daily activities and quality of life. Understanding its anatomy, causes, and progression helps guide management options. Ultrasound-guided cortisone injections represent a precise, minimally invasive approach tailored to the needs of each patient.

At Joint Injections, we combine expertise with advanced imaging to deliver care that supports individuals in managing thumb osteoarthritis effectively. This personalised and accurate approach makes ultrasound-guided cortisone injections a valued option within the broader management of this condition.

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