Finger polyarthroses are classified according to the affected joints:

1. Heberden's osteoarthritis:
   • Affects the distal interphalangeal joints.
   • Common symptoms include nodules and deformities at the end joints.
2. Bouchard's osteoarthritis:
   • Affects the proximal interphalangeal joints.
   • Characterized by swelling and stiffness of the affected joints.
3. Thumb saddle joint osteoarthritis (Rhizarthrosis):
   • Affects the thumb saddle joint (carpometacarpal joint), which is crucial for the thumb's gripping function.
4. Generalized osteoarthritis syndrome:
   • Combination of multiple osteoarthritis in the finger joints and other joints such as the knee or hip.

The main causes of finger polyarthrosis can be divided into different categories:

Genetic predisposition:

A familial accumulation indicates a genetic component that increases the risk of arthrosis.

Age:

With increasing age, the regenerative capacity of the joint cartilage decreases, increasing the likelihood of arthrosis.

Mechanical stress:

Repeated overloads, such as those occurring in manual work or frequent typing, promote joint wear.

Gender:

Women are more frequently affected, especially after menopause, which suggests hormonal influences.

Injuries:

Previous injuries or fractures of the fingers can weaken the joint structures and increase the risk of arthrosis.

Inflammatory diseases:

Chronic inflammations, as in rheumatoid arthritis, can promote the development of finger polyarthrosis.

The symptoms of finger polyarthritis vary depending on the severity and affected joints, but typically include:

• Pain:
  • Initially, the pain occurs only under stress, later also at rest.
• Stiffness:
  • Especially in the morning or after longer periods of rest, it is difficult to move the fingers.
• Nodule formation:
  • Heberden's and Bouchard's nodes are visible thickenings on the finger or middle joints.
• Movement restrictions:
  • The gripping function and mobility of the fingers are increasingly restricted.
• Deformities:
  • In the advanced stage, deformations of the affected joints occur.
• Crepitation:
  • Crunching or grinding noises when moving the fingers.

The diagnosis is based on a combination of medical history, clinical examination, and imaging techniques:

• Medical History:
  • The doctor inquires about the symptoms, their duration, and possible family history.
• Physical Examination:
  • Visible nodule formation, swelling, and movement restrictions of the affected joints.
• Imaging Techniques:
  • X-ray: Depiction of joint space narrowing, bone spurs (osteophytes), and deformities.
  • MRI: Helpful in early stages for assessing cartilage and soft tissue damage.
  • Ultrasound: Depiction of inflammatory processes in the joints.

Conservative Therapy

Conservative therapy is the main focus and aims to alleviate symptoms and improve function:

• Physiotherapy:
  • Exercises to strengthen the hand muscles and improve mobility.
  • Heat or cold therapy to relieve pain and inflammation.
• Pain medication:
  • Use of nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen to reduce pain and inflammation.
• Orthopedic aids:
  • Use of splints or braces to stabilize and relieve the affected joints.
• Occupational therapy:
  • Adjustment of daily activities to protect the joints.

Surgical Therapy

In severe cases or with progressive symptoms, surgery may be necessary:

• Joint fusion (arthrodesis):
  • Fixation of the affected joint in a functional position.
• Joint replacement:
  • Use of artificial joints for severely damaged finger or thumb joints.
• Nodule removal:
  • Surgical removal may be advisable for painful Heberden's or Bouchard's nodes.

To prevent finger polyarthrosis, the following measures are recommended:

1. Joint protection: Avoiding overstrain and using ergonomic tools.
2. Regular exercise: Promoting joint health through targeted exercises.
3. Balanced diet: Ensuring adequate supply of vitamins and minerals to support cartilage regeneration.
4. Early treatment of injuries: Immediate care of hand injuries to prevent long-term damage.
5. Weight management: Avoiding overweight, which can increase the strain on the joints.