Entzündliche Fingergelenkspolyarthrose – Herausforderungen in der Diagnostik und Therapie

Zusammenfassung

Eine symptomatische Fingergelenkspolyarthrose (HOA) tritt bei 5–20 % der Bevölkerung ≥ 40 Jahre auf. Die Diagnosestellung erfolgt primär anhand der klinischen Symptomatik mit Schmerzen, knöcherne Verdickungen der Fingergelenke und geringer Morgensteifigkeit. Laboruntersuchungen und Röntgenaufnahmen der Hände können in der Differenzialdiagnostik anderer entzündlicher Gelenkerkrankungen, insbesondere der rheumatoiden Arthritis und Psoriasis-Arthritis notwendig werden. Nicht-pharmakologische Therapieoptionen umfassen Patientenschulung zur Kräftigung der Muskulatur und Mobilisation als auch physio- und ergoherapeutische Behandlungsverfahren. Bei leichten bis mäßigen Schmerzen können topische nicht-steroidale Antirheumatika (NSAR) oder Capsaicin effektiv sein. Zur systemischen Therapie kommen in erster Linie Paracetamol, NSAR und Coxibe in Frage. Innovative Therapieoptionen werden derzeit in klinischen Studien erforscht.

Abstract

Symptomatic osteoarthritis of the hand occurs in 5–20 % of the population ≥ 40 years. The diagnosis is made based on the clinical appearance, e. g. bony enlargements of small finger joints, pain and short morning stiffness. Laboratory or X-ray examinates can however be useful to exclude other rheumatic diseases. Non-pharmacological therapy options include patient education, physio- and occupational therapeutic exercise to strengthen the muscles and mobilisation. Topical non-steroidal anti-inflammatory drugs (NSAID) or capsaicin can be effective for mild to intermediate pain. Systemic therapeutics are paracetamol, NSAID or coxibs. Innovative therapy options are currently under investigation in clinical trials.

Schlüsselwörter

Fingerpolyarthrose - Osteoarthritis - erosive Osteoarthritis

Keywords

osteoarthritis - osteoarthritis of the hand - erosive osteoarthritis

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