Wrist And Hand

Question 1

Differential diagnosis: arthropathy

Answer 1

E.g. osteoarthritis, rheumatoid arthritis, gout

Question 2

Differential diagnosis: trauma

Answer 2

E.g. colles fracture, dislocation of digital joints

Question 3

Differential diagnosis: neural impingement

Answer 3

E.g. carpal tunnel syndrome

Question 4

Differential diagnosis: severe neuropathy

Answer 4

E.g. claw hand, drop wrist

Question 5

Differential diagnosis: tendinopathy

Answer 5

E.g. De Quervain’s disease

Question 6

Differential diagnosis

Answer 6

Trigger finger/ thumb
Fractures and trauma

Question 7

Trigger finger

Answer 7

Nodule forms on the tendon and then gets stuck
To unstick it the movements will be jerky
Sticks, locks, flicks
Splinting and injections can help

Question 8

Dupuytren’s contraction

Answer 8

Nodules and cords from within the palmar fascia and cause contractures
The fascia pulls the finger down
Can be released with surgery

Question 9

De Quervain’s disease

Answer 9

Extensor pollicis brevis and abductor pollicis longus tendon sheath constricts the tendons
Repetitive ulnar and radial deviation
Found in pregnancy or new parents between 30-50 years - constantly picking up and placing down the baby
Squeaky tendon
Splinting and active management can reduce muscle tightness