Finger Osteoarthritis Treatment London | Private Ultrasound Diagnosis & Injections

Finger Arthritis Explained

Basic Finger Joint Anatomy

The anatomy of each of our fingers comprises three joints. Proximally (nearer to the wrist) is the knuckle metacarpo-phalangeal joint (MCP joint). Next down towards the fingers is the proximal inter-phalangeal joint and lastly near to the end of our fingers is the distal inter-phalangeal joint. Each of these joints has a soft tissue capsule surrounding it and is covered on the upper dorsal side by extensor tendons and ligaments which hold the extensor tendons in place and on the palm volar side the flexor tendons run to the end of the fingers bound down by a series of pulley straps. 

Symptoms of Finger Osteoarthritis

Symptoms of finger joint osteoarthritis include progressive stiffness and pain in the joint affected. Some individuals may experience fluid swelling over the joint and over time there may be observable deformities to the joints with the affected joint angulating or giving rise to bony thickening on the top of the joint affected. 

Causes of Finger Osteoarthritis

Finger joint osteoarthritis may affect any of these three joints of any of the fingers. It is most commonly seen at the MCP joints or the DIP joints and the causes are a combination of genetic factors and previous trauma to the bones and affected joints. 

In some individuals due to genetic predisposition there may be widespread osteoarthritic progression of the joints in both hands. 

Diagnosing Finger Osteoarthritis

Ultrasound is an excellent modality for diagnosing osteoarthritis of the finger joints as it is able to easily visualize the characteristic bony margin changes to the joints but also exclude any other diagnosis including injury and inflammation to the tendons as well as using a vascular setting (power doppler) to exclude any obvious immune system triggered inflammation to the joints affected.

Ultrasound Guided Injections for Finger Osteoarthritis

Ultrasound Guided Injections to Treat Finger Osteoarthritis

Due to the very small entry point to the finger joints with a needle to be assured that the accuracy is maintained and the injectate is appropriately injected within the joint capsule these procedures must be guided under ultrasound. 

Two techniques exist for accurately placing the needle within the joint capsule. 

The first technique is what is known as an out of plane technique where the probe is placed longitudinally along the finger and the center line axis is placed directly over the opening to the joint. The needle is guided from the side into the joint along this center axis line.

The second technique is an in-plane technique where the probe is again placed along the finger joint in a longitudinal plane with standoff gel placed at the distal aspect of the finger joint and probe. The affected joint should be slightly flexed and the needle visualized through the standoff gel into the opening at the top of the finger joint.

What to Do After Your Finger joint Injection

Needle Path & Post-Injection Pain
The finger joints are accessed via the top (dorsal) aspect of the fingers when administering an ultrasound guided injection. The procedure itself may be painful in some circumstances but this is reduced with  an experienced clinician and the use of ultrasound for guidance. This pain will settle quickly but in some individuals a post in post-injection flare may occur for 2-3 days because the medication and injectate react with the synovial fluid in the injected finger joint.
If this occurs, over-the-counter painkillers (as directed on the patient information leaflet) can be taken.

Wound Care & Infection Risk
Avoid exposing the needle site to public or dirty water (e.g., swimming pools, hot tubs, lakes) for 2–3 days after any ultrasound-guided injection, due to the small infection risk.

Activity Guidance
After a finger arthritis injection, it is advisable to avoid any significant increase in activity for 10 days.
This allows the anti-inflammatory properties of the steroid to work optimally.
Following this period, sensible increases in activities and following some basic physical therapy exercises may help. 

Follow-Up
Following an finger arthritis injection, please contact me immediately if you experience any difficulties.

Other Treatments for Finger Joint Arthritis

Finger Joint Contrast Bathing for Osteoarthritis

Mobility Physical Therapy Exercises for Finger Osteoarthritis

Strengthening Physical Therapy Exercises for Finger Osteoarthritis

Finger Joint Osteoarthritis | Evidence base

Finger joint arthritis, most commonly affecting the distal and proximal interphalangeal joints, is a degenerative condition characterised by pain, stiffness, swelling, and reduced hand function. Symptoms often fluctuate, with inflammatory flares superimposed on chronic structural change. Evidence supports a conservative, symptom-guided approach, including education, activity modification, splinting, and hand therapy. Intra-articular corticosteroid injection has moderate evidence for short-term pain relief in painful, inflamed finger joints, particularly during acute flares or when pain limits function. Due to the small joint size and frequent osteophyte formation, ultrasound guidance significantly improves injection accuracy compared with landmark techniques and reduces the risk of extra-articular injection. While long-term outcomes are similar, studies suggest US-guided injections provide more reliable early symptom relief and improved patient comfort, especially in advanced disease or when previous blind injections have failed. Repeat injections should be used cautiously due to diminishing benefit and potential local tissue effects. Surgical intervention is reserved for severe, refractory cases. Overall, ultrasound-guided intra-articular injection is a useful adjunct for short-term symptom control in finger joint arthritis and can facilitate improved hand use and engagement with rehabilitation strategies.

Questions about your finger pain?