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PIP Arthritis M19.049 715.14

PIP arthrodesis xray

PIP arthrodesis lateral view

PIP fusion xray

PIP fusion lateral view

synonyms: proximal interphalageal joint arthritis

PIP Arthritis ICD-10

PIP Arthritis ICD-9

  • 715.14 Osteoarthritis, localized, primary; hand

PIP Arthritis Etiology / Epidemiology / Natural History

  • Etiology: osteoarthritis, posttraumatic arthritis, rheumatoid arthritis

PIP Arthritis Anatomy

  • see Hand anatomy.
  • PIP joint arthroplasty is dependent upon radial collateral ligament stability

PIP Arthritis Clinical Evaluation

  • Pain and loss of motion in PIP joint of affected digit. RA patients often have gross deformity / subluxation

PIP Arthritis Xray / Diagnositc Tests

  • P/A, lateral and oblique views of affected finger / thumb demonstrate varying degrees of Joint space narrowing, sclerosis, osteophytosis

PIP Arthritis Classification / Treatment

  • Index Finger
    Treatment = PIP arthrodesis (maintains pinch strength, better reliability over long term compared to arthroplasty for the index finger. 
  • Long, Ring, Small Finger with soft-tissue laxity
    Treatment = semiconstrained silicone PIP arthroplasty
  • Long, Ring, Small Finger with stable joint
    Treatment =nonconstrained pyrolytic carbon or metal-plastic PIP arthroplasty

PIP Arthritis Associated Injuries / Differential Diagnosis

  • PIP Dislocation
  • DIP Arthritis
  • MCP arthritis

PIP Arthritis Complications

  • Instability
  • Infection
  • Flexion deformity
  • Squeaking
  • Loss of motion

PIP Arthritis Follow-up Care

PIP Arthritis Review References

  • Greens Hand Surgery
  • Pellegrini VD Jr, Burton RI. Osteoarthritis of the proximal interphalangeal joint of the hand: arthroplasty or fusion? J Hand Surg Am. 1990 Mar;15(2):194-209. PubMed PMID: 2133611
  • Branam BR, Tuttle HG, Stern PJ, Levin L. Resurfacing arthroplasty versus silicone arthroplasty for proximal interphalangeal joint osteoarthritis. J Hand Surg Am. 2007 Jul-Aug;32(6):775-88. PubMed PMID: 17606054