X-rays will usually confirm the diagnosis.
Treatment is tailored to the severity of disease. In mild cases lifestyle modification, simple analgesia and possible splintage may suffice. In others, a steroid injection into the basal thumb joint can be helpful. In fact the majority of patients who get as far as presenting to a hand surgeon will probably have a steroid injection as most will have already tried the simpler treatments. The risks of steroid injections are post-steroid flare, depigmentation and skin atrophy. Your surgeon will discuss these with you.
Occasionally, the X-rays will show arthritis affecting the joint below (the scaphotrapeziotrapezoidal joint, STTJ ).The X-ray below shows a fusion of the STTJ – this is a rather unusual operation and most patients respond to a steroid injection under X-ray guidance thus not requiring the fusion.