Hand clinics
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The subsesamoid joints of the thumb are a common site of arthritis, but their small size makes diagnosis of disorders challenging. The sesamoid and subsesamoid joints may also be injured acutely with the volar plate complex during hyperextension injuries, and may sometimes produce mechanical dysfunction. Simple excision of chronically painful sesamoids provides excellent relief.
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Treating patients with osteoarthritis (OA) and rheumatoid arthritis (RA) remains challenging; however, new agents offer the chance for an improved quality of life. As an alternative to traditional nonsteroidal anti-inflammatories, cyclooxygenase-2 inhibitors provide pain relief for OA and RA patients with possible fewer side effects. ⋯ Rheumatoid arthritis research has led to an improved understanding of the inflammatory cascade and an appreciation of the early tissue destruction. A new treatment philosophy has thus emerged along with the development of new biologic agents; the latter, along with combination therapy and a new disease modifying antirheumatic drug, leflunomide, have greatly expanded the chances for disease control in RA patients.