Midcarpal Arthritis
What is Midcarpal Arthritis?
Midcarpal arthritis is a degenerative condition affecting the midcarpal joint, which is located between the proximal and distal rows of the carpal bones in the wrist. This joint plays a key role in wrist motion and load transmission. Arthritis in this region causes the cartilage between the bones to wear down, leading to pain, stiffness, and reduced wrist function. It often results from previous wrist injuries or long-standing joint instability.
Causes of Midcarpal Arthritis
Midcarpal arthritis can be caused by a number of underlying conditions, most of which involve joint damage or abnormal loading patterns. Common causes include:
- Post-traumatic arthritis, especially after wrist fractures or ligament injuries
- Scapholunate advanced collapse (SLAC), resulting from chronic ligament tears
- Scaphoid nonunion advanced collapse (SNAC), caused by untreated scaphoid fractures
- Osteoarthritis, due to aging and general joint wear and tear
- Inflammatory arthritis, such as rheumatoid arthritis or lupus
- Kienböck’s disease, involving avascular necrosis of the lunate bone
These conditions lead to joint surface breakdown and chronic inflammation.
What are the Symptoms of Midcarpal Arthritis?
The symptoms of midcarpal arthritis typically develop gradually and may worsen with activity. Common symptoms include:
- Pain in the central or dorsal (back) part of the wrist
- Stiffness, particularly in the morning or after rest
- Swelling or tenderness over the midcarpal area
- Decreased grip strength
- Clicking or grinding sensation, especially with wrist movement
- Difficulty with tasks requiring wrist flexibility, like opening jars or lifting
How is Midcarpal Arthritis Diagnosed?
Diagnosis involves a combination of physical examination and imaging studies:
- Clinical exam, to assess pain, range of motion, and joint stability
- X-rays, to evaluate joint space narrowing, bone spurs, or collapse patterns
- MRI or CT scans, for detailed visualization of cartilage damage and early-stage arthritis
- Diagnostic injections, to confirm the specific source of wrist pain
- Accurate diagnosis helps guide appropriate treatment planning.
What are the Treatment Options for Midcarpal Arthritis?
Treatment depends on the severity of symptoms and the degree of joint damage:
- Activity modification, to reduce repetitive strain
- Wrist splints or braces, for support and symptom relief
- NSAIDs or corticosteroid injections, to manage inflammation
- Hand therapy, to improve mobility and strength
- Surgical options, including midcarpal fusion or proximal row carpectomy in advanced cases
- Total wrist arthrodesis or replacement, in severe or widespread arthritis