Thumb Basilar Joint Arthritis Classification

 Eaton Littler Stage I thumb arthritis Eaton Littler Stage I
  • Normal joint with the exception of possible widening from synovitis
  • Treatment = Ligament reconstruction or metacarpal extension osteotomy
  1. Normal articular countours, slight joint space widening caused by effusion/synovitis/ligamentous laxity.

 
Eaton Littler Stage II thumb arthritis Eaton Littler Stage II
  • Joint space narrowing with debris and osteophytes less than 2 mm in size.
  • Treatment = LRTI, or trapeziometacarpal fusion or implant arthroplasty.
  1. Mild joint narrowing, osteophytes less than 2mm in size, minimal sclerosis/cystic changes.
Eaton Littler Stage III thumb arthritis Eaton Littler Stage III
  • Joint space narrowing with debris and osteophytes greater than 2 mm in size
  • Treatment = LRTI, or trapeziometacarpal fusion or implant arthroplasty.
  1. Marked joint space narrowing, sclerosis and cystic changes in the trapeziometacarpal joint.
  2. Osteophytes >2mm
Eaton Littler Stage IV thumb arthritis Eaton Littler Stage IV
  • Scaphotrapezoidal joint space involvement in addition to narrowing of the trapeziometacarpal joint.
  • Treatment = LRTIwith complete trapezium excision.
  1. Marked joint space narrowing, sclerosis and cystic changes in the trapeziometacarpal joint.
  2. Osteophytes >2mm
  3. Joint space narrowing, sclerosis and cystic changes in the scaphotrapezoidal joint.
  Eaton Littler Staging (Eaton RG, J Hand Surg 1984;9A:692), (Eaton RG, Hand Cin 1987;3:455)