Adult Hand Problems Flashcards
what is a ganglion cyst?
outpouchings of synovial fluid at joints
where are ganglion cysts common?
DIPs (mucous cyst)
wrist
ankle
knee (Baker’s cyst)
what condition are ganglion cysts associated with?
OA
presentation of ganglion cyst
pain due to underlying OA
firm, smooth, rubbery cysts that trans-illuminate
management of ganglion cysts
DO NOT try to burst needle aspiration (common reoccurrence) excision (cosmetic reasons)
what is trigger finger?
stenosing tenosynovitis leads to swelling of sheath which catches on A1 pulley
presentation of trigger finger
pain and clicking over MC head with triggering (sticking in flexion)
what do you need to distinguish trigger finger from?
Dupuytren’s
difference between trigger finger and Dupuytren’s?
Dupuytren’s is unable to straighten
management of trigger finger
most resolve spontaneously
splint to prevent flexion
surgical division of A1 pulley BUT NOT others
what is DeQuervain’s tenosynovitis?
inflammation of sheath over radial styloid process at wrist that involves tendons that move the thumb (APL and EBP)
who is DeQuervain’s tenosynovitis more common in?
women
pregnancy
RA
presentation of DeQuervain’s tenosynovitis
red
swollen
pain
diagnosis of DeQuervain’s tenosynovitis
Finklestein’s test
what do you need to rule out in DeQuervain’s tenosynovitis?
CMC OA
management of DeQuervain’s tenosynovitis
conservative
surgical decompression
what is Dupuytren’s contracture?
proliferative connective tissue disorder with hyperplasia of palmar fascia forming contractures at MCP and PIP joints leading to FFD
what is Dupuytren’s contracture associated with?
genetics DM alcohol/cirrhosis phenytoin AEDs trauma Lederhosen's Peyronie's
who is Dupuytren’s contracture more common in?
men
presentation of Dupuytren’s contracture
painless gradual progression of flexion
diagnosis of Dupuytren’s contracture
feel cords
table top test (unable to flatten hand)
management of Dupuytren’s contracture
lifestyle
stretches
fasciectomy
amputation
what is a sebaceous cyst?
cyst that originates at hair follicles and is filled with keratin
presentation of sebaceous cyst
slow growing
painless
management of sebaceous cyst
can become infected so need excision
what is paronychia?
infection within the nail fold
cause of paronychia
often in children due to nail biting
presentation of paronychia
pus and other inflammatory features around nail bed
management of paronychia
antibiotics
incision and drainage
presentation of scaphoid fracture
pain and tenderness in anatomical snuffbox
presentation of radial nerve palsy
wrist drop
what is Boxer’s fracture?
5th metacarpal
which direction is IPJS dislocation
always posterior due to hyperextension or direct axial blow
management of IPJs dislocation
buddy strap OR
volar slab in Edinburgh position
