Unilateral Osteoarthritis — “The Working Hand”

This 73-year-old woman had no symptoms in her left hand. Figure 1. A 73-year-old woman was seen in the Neurology Clinic for follow-up of secondary progressive multiple sclerosis. She had had a progressive left hemiparesis for 30 years. She reported mild intermittent pain, joint swelling, and stiffness of her right hand, fingers, and wrist. She had no symptoms of arthritis in her left hand. Physical examination revealed a left hemiplegia. Muscle strength was 1/5 in the left wrist and hand, with no joint swelling or deformity; the left hand appeared to be somewhat smaller than the right. In sharp contrast, examination of the patient's right hand revealed typical changes of.