The basal joint pain syndrome.

Disabling trapeziometacarpal osteoarthritis is often associated with other skeletal or soft tissue pathology that necessitates simultaneous treatment. In this study of 100 trapezium arthroplasties, 65% of the patients required at least one concurrent operative procedure and, overall, 75% have received treatment for related problems before, during, or after the arthroplasty. In order of frequency, scaphotrapezial arthritis, carpal tunnel syndrome, hyperextension deformity of the thumb metacarpophalangeal joint, trigger digits, and tenosynovitis of the wrist have been the most prevalent concomitant conditions requiring surgery. Awareness that trapeziometacarpal arthritis is frequently the focal site of a widespread inflammatory process involving other structures of the hand--termed herein the "basal joint pain syndrome"--is essential to optimal management of patients with pain at the base of the thumb.