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wrist and hand conditions Flashcards

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1
Q

what is a tenosynovitis?

A

an inflammation of the fluid filled synovium within the tendon sheet

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2
Q

what age group and profession is most at risk to develop DeQuervain’s tenosynovitis?

A

female 30-40
hairdressers

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3
Q

what is the DeQuervain’s tenosynovitis?

A

a tenosynovitis of the abductor pollicis longus and the extensor pollicis brevis
usually due to overuse and repetitive strain of the hand (hairdresser, gardener)

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4
Q

what are s&s of DeQuervain’s tenosynovitis?

A

pain at the base of thumb
worse with movement
TTP over abductor pollicis longus and extensory pollicis brevis
palpable tendon crepitus

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5
Q

which special test is positive in DeQuervain’s tenosynovitis?

A

finkelstein

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6
Q

what is the management for DeQuervain’s tenosynovitis?

A

rest and splinting
NSAIDS
manual therapy
surgery

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7
Q

what ligament is injured in the dorsal wrist syndrome?

A

the scapholunate ligament

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8
Q

what are s&s in dorsal wrist syndrome?

A

pain over dorsal wrist
pain on passive wrist extension

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9
Q

which tests are positive in dorsal wrist syndrome?

A

finger extension test
scapholunate instability test

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10
Q

what is Dupuytren’s contracture?

A

fibrous proliferation of the palmar fascia of the hand

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11
Q

which fingers are most commonly affected with Dupuytren’s contracture?

A

4th and 5th digit

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12
Q

what are s&s for Dupuytren’s contracture?

A

flexion deformity of MCP and PIP joints
inability to straighten fingers

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13
Q

which conditions is Dupuytren’s contracture often associated with?

A

alcoholism
diabetes
epilepsy

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14
Q

what is the management for Dupuytren’s contracture?

A

Surgery

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15
Q

which ligament is ruptured in a gamekeepers/skiers thumb?

A

the ulnar collateral ligament of the thumb

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16
Q

what are s&s for a gamekeepers/skiers thumb?

A

laxity to abduct the 1st metacarpal
tenderness on thumb palpation
pain and/or inflammation of ulnar aspect of metacarpal phalangeal joint
weakness to make pinch sign

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17
Q

which test is positive in a gamekeepers/skiers thumb?

A

ulnar collateral ligament test

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18
Q

what is the adviced management for a gamekeepers/skiers thumb?

A

4-6 weeks in a thumb spica cast
if highly unstable refer for surgery

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19
Q

what is a ganglion?

A

a fluid-filled swelling developing near a joint or tendon (synovial fluid leaks out and forms a cyst)

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20
Q

what are the s&s of a ganglion in the wrist/hand?

A

cystic lump on dorsum of hand (feels hard)
mildly tender
mostly harmless (can resolve from itself in one year)

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21
Q

what is the intersection syndrome?

A

inflammation of the crossover between:
abductor pollicis longus
extensor pollicis brevis
extensor carpi radialis longus
extensor carpi radialis brevis

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22
Q

what is the cause of intersection syndrome?

A

repetitive wrist extension

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23
Q

what are s&s of intersection syndrome?

A

swelling and point tenderness (6-8cm proximal to radial styloid process)
crepitus on wrist extension
worse on resisted thumb extension

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24
Q

which tests are positive in intersection syndrome?

Study These Flashcards
A

intersection syndrome test
finkelstein (association with DeQuervain’s)

25
what is Kienbock's disease?
avascular necrosis of the lunate
26
in which population is Kienbock's disease most common?
people between 18-40 yrs, manual labourers (most of them have light wrist trauma)
27
what are s&s of Kienbock's disease?
wrist swelling and tenderness reduced flexion and extension normal pronation and supination reduced grip strength on x-ray: increased density, lucent areas, articular collapse, decrease lunate size
28
what is the treatment for Kienbock's disease?
surgery
29
which tendon is rupture in a Mallet finger?
the extensor tendon at the base of the distal phalax
30
what is the most common site for a Mallet finger?
4th and 5th digit
31
what are the most common causes of Mallet finger?
blow on fingertip (sports injury) RA
32
what are s&s for mallet finger?
finger held in flexion active and resisted extension are impossible passive movement is normal can be inflamed (red hot swollen) when acute chronic: no pain
33
what is the imaging of choice for a mallet finger?
x-ray: may show avulsed fragment of bone
34
what is the management for a mallet finger?
splint finger ice 4-6 weeks to heal
35
what are the s&s of OA of the 1st carpo-metacarpal joint?
constant aching pain around base of thumb crepitus with movement decreased ROM (difficulty holding a mug or turning a doorknob)
36
which joints are most commonly affected in RA of the hands?
MCP PIP carpals ulnar styloid process radiocarpal joint
37
what are the s&s of RA in the hands?
symmetrical and bilateral symptoms fusiform swelling stiffness (takes a long time to ease of with movement) redness & warmth fatigue & weightloss
38
what are the x-ray findings of RA in the hands?
uniform loss of joint space marginal (rat bite) erosion subchondral cyst at the distal radius ulnar styloid erosion widened scapho-lunate joint space
39
what characterises boutonniere deformity?
PIP flexion and DIP extension
40
what characterises a swan neck deformity?
PIP extension and DIP flexion
41
what what is a scapholunate dissociation?
abnormal orientation of the scaphoid relative to the lunate due to injury of the stabilising scapholunate ligament (more severe than dorsal wrist syndrome)
42
what is the injury mechanism of a scapholunate dissociation?
fall onto dorsiflexed hand
43
what are s&s of scapholunate dissociation?
tenderness around dorsal wrist and hand pain in anatomical snuffbox limited grip strength and ROM
44
which test is positive in scapholunate dissociation?
the scapholunate instability (watson) test
45
what is the management for scapholunate dissociation?
surgery
46
which tendons in the wrist and hand are commonly affected by tendinopathies?
extensor carpi radialis longus extensor carpi radialis brevis flexor carpi radialis extensor carpi ulnaris flexor carpi ulnaris
47
how to test for a tendinopathy?
check resisted ROM, if painful it might indicate a tendinopathy
48
where is the triangular fibrocartilage situated?
between the ulnar head, the lunate and the triquetrium
49
what causes a tear in the triangular fibrocartilage?
sudden, forcible supination or pronation of the forearm (racquet sports)
50
what are s&s of a triangular fibrocartilage tear?
pain over distal end of ulna pain and clicking weakness and instability of the wrist painful resisted extension and ulnar deviation reduced grip strengths
51
which tests are positive in triangular fibrocartilage tear?
press test triangular cartilage load test
52
what is the imaging of choice for a cartilage tear?
ultrasound MRI
53
what is the treatment for a fibrocartilage tear?
conservative NSAIDS rest
54
what is trigger finger?
inflammation and constriction of the retinacular sheat, the irritation causes nodules to form on the tendon
55
which fingers are commonly affect in trigger finger?
ring and little finger
56
what are s&s of trigger finger?
pain over nodules pain, stiffness and a sensation of locking and catching when trying to straighten finger pain over base of affected fingers
57
which other condition does a trigger finger commonly associate with?
carpal tunnel syndrome
58
what is the most common population for trigger finger?
diabetic female >60 years
59
what is the treatment of choice for trigger finger?
immobilisation NSAIDS taping

conditions (29 decks)

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