Hand signs Flashcards
(16 cards)
Osteoarthritis
- Is it the most common form of arthritis?
- Is it inflammatory?
- Is it degenerative?
- Involves the breakdown of ________
- Is it symmetrical?
- Which 4 joints does it commonly affect?
Yes
No
Yes
Cartilage
No
Hands, knees, hips, spine
Osteoarthritis: symptoms
- Describe pain
- Describe stiffness
- Describe swelling
- Describe deformity
Pain: typically worsens throughout the day, due to more activity of degenerating joints
Stiffness: usually for less than 30 minutes
Swelling: minimal
Deformity: Bouchard and Heberden nodes
Osteoarthritis: nodes
- Are they bony or soft? Why?
- Are they tender or not?
- What are their names? How do you remember the names?
Bony - due to osteophytes
Not tender
Bouchard nodes (proximal interphalangeal joints; blood pressure) and Heberden nodes (distal interphalangeal joints, HD)
Rheumatoid arthritis
- Is it inflammatory?
- Is it symmetrical?
Yes
Yes
Rheumatoid arthritis
- Is it inflammatory?
- Is it symmetrical?
Rheumatoid arthritis: symptoms
- Describe pain
- Describe stiffness
- Describe swelling
- Describe deformity
Pain usually improves with movement
Stiffness can last for over 1 hour; improves with movement and returns upon cessation of activity; morning stiffness
There is swelling (unlike OA)
Swan neck, Boutonniere, ulnar deviation, rheumatoid nodules
Rheumatoid arthritis:
Describe swan neck deformity
Flexed at distal interphalangeal joint (like a swan)
Hyperextended at proximal interphalangeal joint
Rheumatoid arthritis:
Describe Boutonniere’s deformity
Flexed at proximal interphalangeal joint
Hyperextended at distal interphalangeal joint
Rheumatoid arthritis:
Describe ulnar deviation
When the fingers go towards the pinkie (ulnar) side.
Rheumatoid nodules
- Are they usually found on flexor or extensor surfaces?
- What joints are they commonly found on?
- Can they be painful to touch?
- What kind of tissue are they made of? Thus, what texture are they?
- Extensor
- Elbow, metacarpophalangeal
- Yes
- Subcutaneous - not hard, usually doughy/spongy
Gout
- Is it a type of degenerative or inflammatory arthritis?
- Is it symmetrical?
- Pathophysiology?
Inflammatory
No
Elevated levels of uric acid - precipitate as crystals in the joints.
Gout
- Pain
- Deformity
Can cause pain in some people
Gouty tophi
Gout: gouty tophi
- What are they?
- What colour are they?
- Are they firm? What do they feel like?
- Can they occur in any joint?
- What joints do they commonly occur in? And which one the most?
- Do all patients get gouty tophi?
Crystal deposits about the joints
Yellow
Yes, like chalk
Yes
Hands, feet, wrists, elbows; metacarpophalangeal joint of the first toe.
No
Psoriatic arthritis
- Briefly describe the condition
Psoriasis is a skin condition that can lead to skin plaques
Can lead to arthritis.
Psoriatic arthritis: 2 deformities?
Dactylytis (sausage fingers - where the whole finger is inflamed)
Pitted nails (holes in nails)
Carpal tunnel syndrome:
- What nerve is compressed?
- What is the clinical consequence?
Median nerve
Lost sensation in lateral 3.5 fingers.
