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Objective: Trapeziometacarpal (TM) joint arthritis is a common source of hand pain in patients presenting to the hand surgeon’s clinic. Long-term data on the natural history of symptomatic TM arthritis is lacking.Methods: We identified 251 patients with symptomatic TM arthritis and performed a retrospective chart review which identified treatment modalities (including surgery) and long term outcomes which were assessed via a telephone survey.Results: We found that of the 251 patients who presented with symptomatic TM arthritis, the 114 patients who had surgery had less pain and disability in the long term than those patients who were treated conservatively with splinting or injection (average pain score 1.8 vs. 3.8). However, the majority of patients did not ultimately undergo surgery.Conclusions: Although patients fare better from a pain and function standpoint with surgery, surgery is not inevitable.

We report on a case of digital benign fibroblastic proliferative lesion that aggressively recurred after multiple excisions and showed histologic progression from a Fibrosseous Pseudotumor (FOPT) to Florid Reactive Periostitis (FRP). We recommend caution on incisional biopsies that do not excise the lesion fully based on the clinical course, radiographic, and histologic findings. Our case demonstrates the protean nature of this entity and the difficulty in obtaining an accurate diagnosis based on the clinical course and radiographic and histologic findings.