Radiographically, it is hard to distinguish between osteoarthritis or rheumatoid arthritis or secondary degenerative arthritis. Secondary degenerative arthritis is obviously secondary to something and that something is trauma. This is generally seen in patients 20- 40 years old after trauma. It is more often unilateral. Patients may report limited opening, joint tenderness and crepitus. The condyle will show flattening, lipping or erosion. Unilateral joint involvement helps differentiate secondary degenerative from osteoarthritis which is more often bilateral and in older (50 years or over) females. Treatment is full time splint wear until symptoms improve and then wean down to night time. Corticosteroid injections may also relieve symptoms but need to be limited.