Arthroscopy of Proximal and Distal Interphalangeal Joints

There are technical limitations in interphalangeal finger joint arthroscopy and arthroscopic surgery because the joint cavity is extremely narrow. Proximal interphalangeal (PIP) and distal interphalangeal (DIP) joint arthroscopy provides more precise information regarding intra-articular structure status than alternative imaging modalities. Magnified observation of the articular cartilage and synovial membrane in the dorsal joint cavity and collateral ligaments is possible. However, the palmar portion of the articular cartilage and the volar synovium cannot be inspected even with strong traction force because the PIP and DIP joint space is not wide enough to insert the arthroscope into the palmar cavity. The arthroscope and other instruments should be handled gently to avoid iatrogenic cartilage damage and slippage out of the joint. Arthroscopy may be considered for arthritis evaluation, synovial biopsy, synovectomy, irrigation and debridement, and loose or foreign body removal in the dorsal joint space. Arthroscopic surgery of the interphalangeal joint can be helpful for carefully selected indications.