Common hand conditions Flashcards Preview

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Flashcards in Common hand conditions Deck (38):
1

What is a mucous cyst?

Outpouching of synovial fluid at distal interphalangeal joint

2

What causes mucous cysts?

Osteoarthritis

3

How do mucous cysts present?

Regular appearance
Pain/painless
Fluctuating
Discharging
Deformed nail bed

4

How are mucous cysts managed?

Nothing
Excision

5

Why might mucous cysts warrant an x-ray?

To determine extent of osteoarthritis

6

What are ganglions?

Outpouchings of the synovial cavity

7

Ganglions are most commonly found around the wrist for what reason?

The greater the number of synovial joints the greater the likelihood of synovial cavity outpouching

8

What are ganglions filled with?

Synovial fluid

9

How do ganglions present?

Fluctuating
Painless +/- tightness

10

How are ganglions managed?

Self resolving

11

Why is surgical management avoided in the treatment of ganglions?

They come back

12

Are ganglions related to osteoarthritis?

Occasionally - most often not

13

What is allan's test used for?

To determine if the blood supply of the hand is intact

14

What is trigger finger?

Inflammation and swelling of the tendons running within the flexor tendon sheath causing catching on the pulleys

15

How does trigger finger present?

Pain over A1 pulley (metacarpal head)
Sticking of finger in flexion
+/- forced extension

16

What should be avoided in the management of trigger finger?

Immobilisation

17

What should be found on the hand examination of someone with trigger finger?

Tenderness over A1 pulley
Fixed flexion
Palpable tendon nodule

18

How is trigger finger managed?

Conservatively (spontaneous resolution, splinting)
Steroid & local anaesthetic injection (curative)
Surgery

19

Which compartment does DeQuervians tenosynovitis affect?

First extensor compartment

20

How does DeQuervians tenosynovitis present?

Spontaneous
Painful radial wrist
Swelling
Erythema

21

What test will be positive in DeQuervians tenosynovitis?

Finkelstein's (ulnar deviation of the hand)

22

How is DeQuervians tenosynovitis managed?

NSAIDs
Splint
Rest
Steroid injection
Surgical decompression

23

Where is the pathology in Dupuytrens contracture?

Palmar fascia

24

How common is Dupuytrens contracture?

Very

25

What is Dupuytrens contracture?

Thickening of palmar fascia causing fixed flexion deformity of the fingers

26

How does Dupuytrens contracture present?

Painless
Gradual
Begins as palmar pit or nodule

27

What conditions are associated with Dupuytrens contracture?

Alcoholism
Liver cirrhosis
Diabetes mellitus
Smoking
Epilepsy medications

28

What is Dupuytren's diathesis?

Tendency towards more aggressive disease i.e
Lederhosen's (feet)
Peyronie's (penis

29

What should be found on examination of someone with Dupuytren's disease?

Palpable cords
MCP and/or DIP joint involvement
Positive table top test

30

How is Dupuytren's disease managed?

Conservative (stretching, activity modification)
Surgical (fasciotomy, amputation)
Collagenase injection?

31

Dupuytren's contracture reoccurs after treatment. T/F

True - within several years

32

What is paronychia?

Infection within the nail fold

33

What is a risk factor for paronychia?

Nail biting

34

Which age range most commonly gets paronychia?

Children

35

How is paronychia managed?

Elevation
Antibiotics
Excision and drainage of pus

36

How common is flexor tendon sheath infection?

Rare but surgical emergency

37

How does flexor tendon sheath infection present?

Tracking up palm and arm
Extremely painful
Loss of movement (even passive) due to pain
Tracking lymphangitis

38

How is flexor tendon sheath infection managed?

Tendon sheath wash out

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