M18.0 Bilateral primary osteoarthritis of first carpometacarpal joints

ICD10CM code

#### Name of the Condition
- Bilateral Primary Osteoarthritis of First Carpometacarpal Joints
- Also known as basal joint arthritis.

#### Summary
- Bilateral primary osteoarthritis of the first carpometacarpal joints is a degenerative joint disease affecting the base of the thumbs. It commonly leads to pain and reduced ability to perform tasks requiring pinching or gripping.

#### Causes
- Osteoarthritis results from wear and tear on joints, and this process can affect the carpometacarpal (CMC) joints at the base of the thumbs. Factors include repetitive thumb use or trauma over time, which causes the cartilage to degrade.

#### Risk Factors
- Age: more common in older adults.
- Gender: more prevalent in women.
- Occupational: jobs requiring repetitive thumb movements.
- Previous injuries to the thumb.

#### Symptoms
- Pain at the base of the thumb, especially during movement.
- Swelling and stiffness.
- Loss of thumb strength.
- Difficulty in pinching or gripping objects.
- Deformity or prominence at the base of the thumb.

#### Diagnosis
- Physical examination: Assessment of pain, swelling, and range of motion.
- Imaging techniques: X-rays to check for joint space narrowing or bone spurs.

#### Treatment Options
- Medications: NSAIDs for pain relief.
- Splints or braces: To limit thumb movement and provide support.
- Occupational therapy: Exercises to strengthen the hand and improve function.
- Corticosteroid injections: To reduce inflammation and pain.
- Surgery: Options include joint fusion or reconstruction, typically in severe cases.

#### Prognosis and Follow-Up
- Many patients experience relief with treatment, though it may be chronic. 
- Regular follow-ups may be necessary to monitor symptoms and adjust treatments.

#### Complications
- Progression of joint deformity.
- Chronic pain or disability.
- Decreased hand mobility affecting daily activities.

#### Lifestyle & Prevention
- Maintain hand strength through exercises.
- Modify activities to reduce strain on thumbs.
- Use adaptive tools to ease grip strain.

#### When to Seek Professional Help
- Persistent or worsening pain or functional impairment.
- Noticeable swelling or change in thumb shape.

#### Additional Resources
- Arthritis Foundation: [arthritis.org](https://www.arthritis.org)
- American Society for Surgery of the Hand: [assh.org](https://www.assh.org)

#### Tips for Medical Coders
- Ensure the bilateral nature of the condition is captured.
- Verify the condition's primary classification as osteoarthritis.
- Avoid confusion with other forms of arthritis affecting different joints or parts of the body.

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