CPT® Code 29900

Diagnostic arthroscopy of the metacarpophalangeal (MP) joint is a minimally invasive surgical procedure that allows for direct visualization and assessment of the joint's internal structures. This procedure is particularly useful for evaluating conditions affecting the MP joint, such as synovial inflammation or damage. During the arthroscopy, small incisions, known as portals, are made on the dorsal (back) side of the hand, specifically at the ulnar and radial aspects of the MP joint, which are located next to the extensor muscle tendon sheath. Care is taken to avoid injury to the dorsal venous plexus, a network of veins in the area. To facilitate the procedure, the portals are infiltrated with a local anesthetic, such as lidocaine, and the joint is distended with saline solution to improve visibility. Finger traction is applied to the digit being examined, which helps to further open the joint space. A needle arthroscope, a specialized instrument equipped with a camera, is then introduced into the MP joint. This allows the physician to inspect the joint cartilage and assess the extent of any synovial inflammation present. If necessary, microforceps are utilized to obtain synovial tissue samples from the most inflamed areas of the synovium. These samples are crucial for laboratory analysis, aiding in the diagnosis of conditions such as rheumatoid arthritis. The overall goal of this diagnostic procedure is to provide early detection and intervention for joint diseases, thereby improving patient outcomes.