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MSK SM > Common Hand Conditions > Flashcards

Common Hand Conditions Flashcards

1
Q

What is a mucous cyst

A

An outpouching of snovial fluid from DIP joint OA

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2
Q

Describe what a mucous cyst can do

A

Produce pain
Fluctuate / discharge
Deform nail, cause ridge

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3
Q

What is the treatment for a mucous cyst

A

Left along

Excised

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4
Q

What is a ganglion

A

Outpouching of synovial cavity filled with synovial fluid

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5
Q

Where is a ganglion more commonly located

A

Where there is a high concentration of synovial joint

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6
Q

What is the treatment of ganglions

A

usually leave alone

sometimes excised or aspirated but usually reappear

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7
Q

When a ganglion is aspirated, what is produced

A

A thick gelatinous substance

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8
Q

What is the main difficulty with volar ganglions

A

They are very close to the radial artery

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9
Q

Where might the synovial fluid of a ganglion come from

A

The flexor tendon at the base of the fingers

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10
Q

What do tendons in the hand run within

A

The flexor tendon sheath

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11
Q

What is the common presentation of a patient with trigger finger

A

The sticking of one finger (usually in flexion)

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12
Q

On examination of trigger finger, what is the main difference between this and Dupuytrens

A

In Dupuytrens you can feel the cord

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13
Q

Where would you feel a nodule in a patient with trigger finger

A

On the MCP and when the patient bends their finger the nodule underneath the tendon is palpable

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14
Q

What is the conservative management for Trigger finger

A

Often resolves spontaneously

Splint to prevent flexion

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15
Q

What is the step in between conservation and surgery

A

Tendon sheath injection

  • steroid +LA
  • often curative
  • may be repeated up to 3x
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16
Q

What is the surgical management for a atient with Trigger Finger

A

Under GA or LA

divide the A pulley

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17
Q

What part of the hand does DeQuervain’s tenosynovitis affect

A

The 1st extensor

18
Q

What do patients with DeQuervain’s tenosynovitis complain of

A

Pain in the thumbs and the tendons

19
Q

Why does pain arise in DeQuervain’s tenosynovitis

A

Tendons are passing through an inflammed sheath which is very tender and often quite swollen

20
Q

What is the test for DeQuervains tenosyovitis

A

Finklestein’s test

21
Q

What is the management for DeQuervains

A 
NSAIDs 
Splint 
Rest 
Steroid injection 
Surgery - decompression
22
Q

Describe Finklestein’s test

A

Make a fist with the thumb inside and ulnar deviate

23
Q

What is Dupuytren’s contracture

A

Thickening and contracture of subdermal fascia leading to fixed deformity of fingers

24
Q

How far up cant the cords in Dupuytren’s contracture go?

A

As far up as the DIP joint

25
Q

In the early stages, what can Dupuytren’s contracture come out as

A

A bit of a pit

26
Q

Dupuytren’s contracture is generally painful or painless?

A

Painless

27
Q

What fingers are most commonly affected by Dupuytren’s contracture

A

ring and little fingers but it can also affect the thumb

28
Q

What is a big indication for surgery

A

When the patient can’t put their hands flat on the table

29
Q

What other parts of the body can be affected by Dupuytren’s contracture

A

Penis and feet

30
Q

What joints of the hands are involved in Dupuytren’s contracture

A

MCP and PIP but not the DIP

31
Q

What is the conservative management for Dupuytren’s contracture

A

Stretches and activity modification

32
Q

What are the surgical options for Dupuytren’s contracture

A

Segmental fasciotomy
fasciectomy
demofasciectomy
amputation

33
Q

Does Dupuytren’s contracture ever come back

A

always

34
Q

The skin graft in a dermofasciectomy usually comes from where and why

A

From the inner arm

It does not grow hair and skin is in excess

35
Q

What is paronychia

A

Infection within the nail fold

36
Q

What is the main risk of paronychia

A

Nail biting

37
Q

What is the management for paronychia

A

Elevate
Antibiotics
Incise and drain collection

38
Q

Who is most likely to develop a paronychia

A

Children

39
Q

What is a flexor tendon sheath infection

A

An infection within the sheath, tracking up the palm and arm

40
Q

Describe the symptoms of a flexor tendon sheath infection

A

Extreme pain
limited extension dye ti pain
erythema

41
Q

What is the treatment for a flexor tendon sheath infection and when should this be done?

A

A wash out tendon sheath

SURGICAL EMERGENCY

MSK SM (42 decks)

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