Finger/Hand Signs Flashcards
What is Dupuytren contracture?
Progressive fibroplasia of the palmar fascia resulting in a flexion contracture of the fingers
Which fingers does Dupuytren contracture most commonly affect?
Ring and little fingers
Risk factors for Dupuytren contracture?
Male Family history of it Diabetes! Alcoholic cirrhosis! Phenytoin use (epileptic) Trauma AIDS!
More rare:
Peyronie disease
Ledderhose disease
Dupuytren contracture presentation on examination?
Thickened palmar aponeurosis is palpable
Treatment for Dupuytren contracture?
Excision of the thickened part of the aponeurosis
What is “trigger finger”?
Difficulty in extension of the finger caused by disparity in size between flexor tendon sheath and the tendon within it
- finger remains flexed until passively extended with a “click”
Is there association of alcohol excess with incidence of trigger finger?
No association with alcohol excess (much more likely to be Dupuytren contracture if so)
What is “asterixis”?
A jerking flexion-extension movement of the hand seen when arms are placed in an outstretched position with the wrists cocked back
- “liver flap”
What condition is asterixis associated with?
Hepatic encephalopathy
When should asterixis be tested for?
In all patients with liver disease who present with:
- an acute deterioration of disease
- worsening ascites
- confusion
- agitation
- reversal of sleeping pattern
- stupor
If positive alongside these then liver encephalopathy strongly suggested
