Approach to Elbow/ Wrist/ Hand Complaint Flashcards
what is another name for nursemaid’s elbow?
subluxation of the radial head
what happens in cases of subluxation of the radial head?
the annular ligament slips out of the radial head and gets trapped in the radiohumeral joint
what is another name for golfer’s elbow?
medial epicondylitis
what is medial epicondylitis caused from?
inflammation of the flexor tendons
what is another name for tennis elbow?
lateral epicondylitis
what is the cause of lateral epicondylitis?
excessive hyperextension/ inflammation of extensor tendons
how are you able to distinguish between bursitis versus effusion?
if you are able to fully extend at the elbow without severe pain then it is bursitis without effusion
what is the distribution of the radial nerve on the hand?
the dorsal aspect covering the thumb and proximal portions of the index and middle finger and half of the proximal ring finger
what is the distribution of the ulnar nerve?
the dorsal and palmar aspect of the 5th digit and the other half of the ring finger
what is the distribution of the median nerve?
the palmar aspect of the hand covering the thumb and the index, middle, and half of the ringer finger as well as the dorsal aspect of the distal index and middle finger as well as the distal 1/2 of the ring finger
what is carpal tunnel caused by?
compression of the median nerve
what is the classical presentation of carpal tunnel syndrome?
pain and paresthesia along the first three and half digits
What are the specialty tests used for carpal tunnel syndrome?
tinels and phalens
what does tinels test look like?
compression of the median nerve by tapping on the nerve
what does phalens test look like?
flexion of the wrist to compress the median nerve
what is de quervain tenosynovitis?
recurrent inflammation of the tendon and synovial sheath covering the extensor pollicis brevis and abductor pollicis longus
what is the classical presentation of de quervain tenosynovitis?
radial wrist pain (over the radial styloid) at the base of the thumb especially with movement of the thumb
what specialty test is used for de quervain tenosynovitis?
finkelstein’s test
what is the classical presentation of trigger finger?
pain, locking, and clicking of the MCP joint
what is the classical presentation of dupuytren’s contracture?
thickening on the palmer surface (painful or painless), cord-like structure and flexed digit with palpable cord
what is the classic presentation of a scaphoid fracture?
pain on the radial aspect of the wrist and reduced grip strength after FOOSH
what would be an exam finding of a scaphoid fracture?
tenderness on anatomic snuff box
what is a boxer’s fracture?
fracture of the metacarpal neck (usually 5th digit but can involve the 4th)
what is the classic presentation of colles fracture?
wrist pain with possible deformity as well as tenderness over fracture site on radial aspect of wrist
what does rheumatoid arthritis most commonly affect?
the MCP and PIP joints of the finger
what happens to the radial head when the wrist pronates?
it will glide posteriorly
what happens to the radial head when the wrist supinates?
it will glide anteriorly
if you have a radial head anterior/ wrist supination somatic dysfunction, where is the direct barrier of the wrist?
wrist pronation
what is the mechanism for a posterior radial head somatic dysfunction?
fall prone/ forwards
what is the mechanism for an anterior radial head somatic dysfunction?
fall supine/ backwards
