Common Hand Conditions Flashcards
which condition causes an outpouching of synovial fluid from DIP joint?
mucous cyst
why do you get outpouching of fluid in the DIP joint?
it is very small so there is nowhere for the fluid to go
what are nail changes caused by a mucous cyst?
nail ridges
treatment for a mucous cyst?
left alone
excision
why are ganglions most common on the wrist?
they occur in synovial cavities so will be prominent in places with a high conc of synovial joints
what is contained in a ganglion?
synovial fluid
are ganglions or mucous cysts painful?
mucous cysts
treatment for ganglions?
will resolve over time
do ganglions stay constantly or come and go?
come and go
management of ganglions?
aspiration
excision
what does the flexor tendon sheath do?
holds tendons on to bone rather than letting them bowstring
clinical presentation of trigger finger?
patient cant bend finger, cant extend it then it just triggers
how do dupuytrens and trigger finger differ in presentation?
trigger finger will move
dupuytrens doesnt
how to examine if a patient does/doesnt have trigger finger?
feel over nodule and get them to move finger, if sore over nodule its trigger finger
pathology of trigger finger?
swollen tendon = irritation
tendon gets caught on edge of A1 pulley
triggering starts
what happens to a severe trigger finger?
may need to use other hand to extend the finger or cant extend it at all
management of trigger finger?
leave it
splint to prevent flexion
injected steroid
surgery to divide A1 pulley
where should you inject steroids for trigger finger?
base of finger between tendon and fibrous sheath
what pulley is essential for finger function?
A2
is dequervains tenosynovitis painful?
yes
treatment for dequervains?
NSAIDs splint rest steroid injection decompression surgery
what does dupuytrens start as?
palmar pit/nodule
causes of dupuytrens
genetics alcohol/cirrhosis smoking epilepsy diabetes
examination of dupuytrens?
feel cords
MCP/PIP joint involvement
table top test
treatment for dupuytrens?
stretches
fasciectomies
amputation
collagenase injection
pathology of dupuytrens?
metaplasia of aponeurosis which causes fibroblasts to turn into myofibroblasts causing them to contract
what does the aponeurosis of the palm do?
stops palm moving around eg when gripping it stops skin sliding over palm
what is paronychia
infection within nail fold
who gets paronychia?
children
causative factors of paronychia?
nail biting
management of paronychia
antibiotics
elevate
incise and drain pus
is a flexor tendon sheath infection common?
no
is a flexor tendon sheath infection a surgical emergency?
yes
where can a flexor tendon sheath infection go?
palm then arm
what tendons run in the digit?
FDS
FDP
why would a dupuytrens contracture reoccur after treatment?
some myofibroblasts are left over
why should you check the lymph nodes of the arm in flexor tendon sheath infection?
to see if infection has spread there
