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Carpometacarpal (CMC) Joints Exam

  • The exam of the 2nd through 5th CMC joints begins by assessing the joints for deformity, bony tenderness, joint tenderness, and /or swelling.
  • Next the 2nd through 5th CMC joints' passive and active range of motion should be noted.
  • X-rays including AP, lateral and oblique views should be obtained to look for signs of fracture, joint subluxation, and/or joint dislocation.
  • A CT scan maybe needed to evaluate the details of any fracture patterns.
Diagrams & Photos
  • The 2nd through 5th CMC joints.
    The 2nd through 5th CMC joints.
Key Points
  • The base of the 5th metacarpal has a convex facet articulates with a concave hamate facet to produce a saddle joint.
  • The complexities of the 5th CMC joint make the evaluation of the fracture pattern and displacement of the baby Bennett fracture dislocation difficult.
  • Dissections of the 2nd through 5th CMC joints have shown minimal degenerative changes in these joints.  The OA findings range from 6% to 9%. 
  • Imaging of this joint frequently needs to be augmented with a 60 degree oblique X-ray view and/or CT scanning.