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Dear expert team,

Due to rhizarthrosis on the left and right side with severe pain and limited in movement, I am supposed to present to a hand surgeon.

Previous treatments: brace for immobilization, cast for three weeks (Jan 2012), injections (local anaesthetic), pain therapy: Arcoxia®(etoricoxib), ointments.

I am an adult CF patient and PSA positive; the last treatment for this was in April 2012. I am taking Zithromax® (Azithromycin) 250mg every two days as long-term therapy, inhaling colistin and Pulmozyme®(DNAse).

In case the hand surgeon finds that I should get surgery, I am very unsure whether I should get it done. I am a bit anxious due to the germ colonization with CF.

One of your answers on joint pain says: “There are patients who have pain in some phases of their lives and only rarely or not at all later, so that there is a good chance for it to improve.” This, on the other hand, gives me hope, of course.

Kind regards

Rhizarthrosis is arthrosis of the thumb saddle joint which mostly occurs in patients above 40 years of age. Unfortunately I do not know how old you are, whether there have been cases of rhizarthrosis in your family and how the diagnosis was made (X-ray?). If conservative options are exhausted and the diagnosis is correct, there is nothing to be said against surgery even for a CF patient. The procedure, most frequently a so-called resection arthroplasty, is usually done on an outpatient basis.

If, however, the pain is due to so-called CF arthritis (in order to distinguish this, an X-ray will be helpful – it will be normal with CF arthritis, but not with rhizathrosis), you should wait and talk to your CF doctor about this.

Kind regards
Prof. Dr. Joachim Bargon