Joe A Shaw PA-C - 8/6/2008

Question
I have extreme pain and swelling at the thumb base and wrist. I grasp alot(7 1/2 hrs a day,5 days a week) for a living. I recently had an x-ray taken of my thumb and wrist and they told me I have an accessory ossicle at the base of the first carpometacarpal joint and that I have degenerative changes at the second metacarpal phalangel joint and at the base of the thumb. They gave me a thumb spica splint,apply ice & told me to take tylenol and to see a hand surgeon. Why do I have to see a surgeon?

Answer
Lynne,
I guess you don't have to see the surgeon..they should have explained that you are seeing a surgeon to see if he thinks surgery would help the pain you are in, since you describe it as "extreme". Accessory ossicles are nothing more than normal variants..ie some people have them some people don't. It is just an extra little oval shaped bone..it may be causing your pain or the degenerative changes could be more likely the cause. I would try 1 or 2 cortisone injections first..then if not better..surgery may be offered to remove and clean up the degenerative changes/arthritis you have.