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sandyle909's version from 2016-09-10 22:13

Section

Question Answer
Radial deviation OA
Ulnar deviation RA
Swan Neck hyperextension of PIP joints with fixed flexion of DIP
Boutonniereflexion of PIP joint with hyperextention of DIP joint
NodesHerberden & Bouchard nodes
Rheumatoid Arthritis Ulnar deviation
swelling at MCP and PIP nodes
Herberden's NodesOsteoarthritis (OA)
not characteristic of rheumatoid arthritis
*dorsolateral aspects of DIP joints
Bouchard's NodesRheumatoid Arthritis or Osteoarthritis
nodes at *PIP joints, less common in OA
boney enlargement (not due to rheumatoid inflammation)
Rheumatoid nodulescommon on dorsum of hand
Trigger Thumb/Fingerflexor tendon becomes irritated and inflamed forming nodule
Nodule unable to pass through A1 pulley freely
Inspection/Palpation: nodule at volar(palmar) aspect of MCP
ROM: digit catches or locks with passive/active flexion of IP/PIP
Concerns: contracture if no tx.
Dupuytren's ContractureConnective tissue disorder - palmar fascia
Thickened fibrotic cord with flexion contracture of fingers
Inspection/Palpation: Painless mass that develop into cords along palm
RF/ SF affected most often
ROM: unable to flatten hand on table
Septic TenosynovitisInfection in the space between the two layers of synovium which cover the flexor tendons of the fingers and thumb
Cause: puncture wounds
Inspection/Palpation: swelling/tenderness
ROM: reduced
Digital Ischemiaischemia may be transient or persistent
Raynauds, Buerger's (secondary to gangrene), Septic Shock, Tissue strangulation (hair)
Bennett's Fracture (of the hand)Fracture fo the base of 1st MC
residual angulation of 20-30 degrees may be acceptable depending on patient's age and clinical appearance of thumb
Innervation of the handRadial, Ulnar, Median (look at chart)
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