Metacarpophalangeal joint pain can be caused by arthritis, trauma, bone cysts, gout, and other underlying conditions. Rheumatoid arthritis is the most common cause, while osteoarthritis and post-traumatic arthritis are also common. Repetitive use and trauma can also cause pain, as can gout and psoriasis. Cysts, such as bone cysts, ganglion cysts, and dermoid cysts, could also be the cause.
Arthritis is the most common cause of metacarpophalangeal joint pain, although the condition can be attributed to a number of different problems, including trauma, caused by repetitive use or injury, bone cysts, and other underlying conditions such as gout. People typically have one metacarpophalangeal joint, also known as the MCP or MC joint, per finger. These joints play a vital role in finger and hand movement, and the pain can inhibit a number of daily activities. Most of the time the pain occurs all at once, which means that all the joints in one hand become inflamed together, but not always. Much depends on a person’s structural anatomy and the underlying cause of the pain.
Basics of articulations
In people, the MCP joints are essentially the knuckles where the bones of the hands first connect to the long middle bones of the fingers. More scientifically speaking, they are where the heads of the metacarpal bones meet the bases of the proximal phalanges. The bout involves a number of ligaments and small tendons and plays a vital role in finger movement and accuracy. Metacarpophalangeal joint pain is often disabling because these “hinged” joints are essential for a variety of fine motor tasks and activities of increased power or grip.
Rheumatoid arthritis
The most common cause of metacarpophalangeal joint pain is rheumatoid arthritis. This inflammatory disease occurs when the lining of joints, especially those in the hands and fingers, produces substances that eat away at the cartilage, ligaments and tendons in the area. When rheumatoid arthritis occurs in the MCP joints, it can cause not only pain but also permanent damage, sometimes causing the fingers to move toward the ulnar side of the hand, the little finger side. This can be disfiguring and can dramatically impair hand movement and function.
Other forms of arthritis
Osteoarthritis and post-traumatic arthritis are generally the second most common causes of pain in this joint. These are more general forms of joint deterioration that typically occur as an aspect of old age or, in the case of post-traumatic exacerbations, accidents or injuries. The main symptom is the wearing out or deterioration of the protective cartilage that covers the bone at the joint. These types of arthritis typically affect the larger joints before they affect the fingers, but not always, particularly when the hands have been injured or otherwise compromised.
Repetitive use and trauma
Trauma or injury to the hands and fingers can also cause pain, either from soft tissue edema that limits joint motion or from actual damage to the joint. This type of pain sometimes goes away on its own once the toes have healed, particularly if the injury wasn’t severe enough to cause permanent damage. A hand that is bruised from being slammed into a door, for example, is more likely to fully recover than one that requires surgery or one in which the bones have actually been broken. In these cases the joint pain may be longer lasting, particularly if the joints have healed improperly.
Repetitive use can also wear down the cartilage in the joints, although this often happens slowly over time, so it’s harder for people to pinpoint a specific cause. People with repetitive injuries often complain of aching or deep joint pain during fine motor activity, but the pain is not necessarily always present and is rarely accompanied by the deformity that is evident with rheumatoid arthritis.
Gout and skin disorders
Another non-traumatic cause of pain is gout. Gout is a very painful buildup of uric acid that most often occurs in the big toe joint, but can also occur in the MCP joints, particularly where the thumb joins the hand. Joints affected by gout tend to be bright red, swollen, and often warm to the touch.
Psoriasis is an autoimmune disease that is best known for its impact on the skin, but it sometimes causes pain and disability in the joints of the body before the reddened skin lesions so characteristic of the disease appear. People suffering from this condition typically have scaly, scaly skin over large areas of the body. The discomfort and itchiness of the condition sometimes causes them to overlook MCP joint pain because their attention is more focused on the external symptoms, but in many cases, if there is psoriasis on the hands, it is likely that the inflammation of the joints is also finger joints.
Cyst
Even benign bone cysts could be the culprit, particularly if the sufferer is a boy or a teenager. Young men are more prone to bone cysts than young women in part because of how quickly their bones move and develop during puberty. A cyst is basically an errant bobble of fluid that builds up and forms a growth; when this happens on or near the finger joints, people often feel pain until the area is drained or the cyst is otherwise removed.
Other types of cysts, such as ganglion or dermoid cysts, could also be the cause, although the diagnosis can be more invasive and is usually only considered when health care professionals have ruled out most other potential causes. Known joint conditions that are rarely seen in the hands and fingers, such as osteochondromatosis, may also need to be investigated in really puzzling cases, and sometimes even rarer conditions such as systemic lupus erythematosus can be diagnosed as the real cause in the process.
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