Radiological findings of rhizarthrosis and their usefulness for therapeutic decision-making

Abstract

Thumb carpometacarpal osteoarthritis is a degenerative condition characterized by pain, weakness, and functional limitation. Although radiographic classifications estimate structural severity, their correlation with clinical symptoms and therapeutic decision-making remains controversial. This study aimed to evaluate the radiographic findings of thumb carpometacarpal osteoarthritis in patients treated at Policlínica Metropolitana de Caracas and determine their usefulness as a criterion for therapeutic decisions between January 2024 and October 2025. Methods: An observational, analytical, retrospective study was conducted. A total of 63 patients aged >35 years with a clinical diagnosis of carpometacarpal osteoarthritis were included. Clinical and radiographic variables were recorded, and severity was classified using the Eaton–Littler scale. Statistical analysis included descriptive methods, linear regression (VAS pain vs. Eaton grade), Spearman correlation, and the Mann–Whitney U test. Results: Most patients were female (65.1 %), with a predominance of the 61–70-year age group (28.6 %). All patients reported thumb base pain, mostly within VAS 5–7 (77.8 %). Mild joint-space narrowing was the most frequent radiographic finding (71.4 %), and Eaton grade II was the most prevalent stage (71.4 %). Linear regression showed a significant association between radiographic severity and pain (β = 0.72; p < 0.001; R² = 0.322). Radiographic severity was strongly correlated with surgical indication (ρ = 0.69; p < 0.001). Surgical treatment was more frequent in Eaton grades III and IV. Conclusion: Radiographic severity was significantly associated with pain intensity and therapeutic decision-making, with surgical treatment being more common in advanced stages of thumb carpometacarpal osteoarthritis.