To report a poorly described etiology for pain after trapeziectomy and soft tissue basal joint arthroplasty, diagnosed with the aid of nuclear imaging.
Five patients (4 women and 1 man), average age 62 years (range, 59-65 years) presented with pain an average of 7 months (range, 2-11 months) after basal joint arthroplasty. The dominant hand was involved in all cases. Advanced imaging including 25 mCi 
Mean follow-up was 40 months (range, 12-60 months). Grip strength improved from a mean of 10.5 to 23 kg, and lateral pinch strength improved from a mean of 3 to 6.75 kg. Radiographic fusion of the index finger metacarpal to capitate was confirmed in 4 of 5 patients; it was indeterminate in one patient who was completely pain-free. Radiographic fusion of long finger carpometacarpal joints was indeterminate in 3 patients. Patient-Rated Wrist Evaluation pain scores improved from 35 to 6, Patient-Rated Wrist Evaluation function scores from 78 to 14, and Quick-Disabilities of the Arm, Shoulder, and Hand scores from 37 to 18.
Therapeutic V.
Impingement between the base of the thumb metacarpal and remaining trapezoid should be considered a potential source of pain after trapeziectomy and soft tissue arthroplasty. Advanced imaging (bone scintigraphy and single-photon emission CT and standard CT) are helpful to confirm the diagnosis.