Overview

The fingers have three types of joints. The MCP (metacarpophalangeal) joints are the large knuckles at the base of each finger, responsible for the power and spread of the hand. The PIP (proximal interphalangeal) joints sit in the middle of each finger and are critical for grip arc and fine motor tasks. The DIP (distal interphalangeal) joints are at the fingertip. Arthritis in any of these joints can result from rheumatoid arthritis (an autoimmune condition producing symmetric, bilateral joint destruction, usually starting at the MCP joints), primary osteoarthritis (wear-related, more common in post-menopausal women, often affecting PIP and DIP joints), or post-traumatic arthritis (joint-surface damage following a fracture or dislocation).

Each pattern has a different trajectory and different surgical implications, but the shared endpoint is a painful, stiff, or deformed joint that interferes with daily tasks. Because the finger joints are involved in virtually every hand function - grip, pinch, keyboard use, writing, and fine motor tasks - even moderate disease can have a disproportionate impact on quality of life compared to arthritis in a larger joint.

Symptoms

• Pain, swelling, and stiffness at the affected finger joints
• Difficulty making a fist or gripping objects
• Visible deformity (ulnar drift in rheumatoid, swan-neck / boutonniere in advanced PIP disease)
• Loss of fine motor function - buttoning, writing, typing
• Symmetric multi-joint involvement (rheumatoid) vs single-joint pattern (post-traumatic)

Who's affected

• Patients with rheumatoid arthritis (often bilateral, symmetric)
• Adults over 50 with primary osteoarthritis of the finger joints
• Patients with previous finger-joint trauma or fracture-dislocation
• Patients with psoriatic or other inflammatory arthropathies

Diagnosis

Diagnosis combines clinical examination and imaging. On examination, the pattern of joint involvement - which joints are affected, whether it is symmetric, and whether there are associated deformities such as ulnar drift, swan-neck, or boutonniere - guides the differential. In rheumatoid disease, blood tests (rheumatoid factor, anti-CCP antibodies, inflammatory markers) and rheumatology input are part of the workup before any surgical planning.

Plain X-rays of the affected hand confirm joint-space narrowing, erosive changes, and deformity. In post-traumatic cases, prior imaging should be reviewed to understand the original injury pattern. Surgical planning for arthroplasty or arthrodesis does not require MRI in most cases; CT may be requested when bone stock assessment is needed before PIP arthroplasty.

Treatment options

Devices used

Procedures

When to see a surgeon

A surgical consultation is appropriate when conservative care - anti-inflammatories, hand therapy, and custom splinting - has not provided adequate relief, or when joint deformity is progressing and affecting function. In rheumatoid disease, surgical referral is coordinated with the treating rheumatologist once medical management has been optimised. A hand surgeon can advise whether arthroplasty (joint replacement, preserving motion) or arthrodesis (joint fusion, eliminating pain at the cost of motion at the specific joint) is the better option for your indication.

GESY coverage in Cyprus

MCP / PIP arthroplasty with KeriFlex® is GESY-covered in Cyprus when performed by a participating hand surgeon at a GESY-contracted hospital. The implant cost is included in the hospital reimbursement.

Finger fusion with KeriFuse® is delivered through the same surgeon network. Contact OrganoGEN for its current GESY status.