Common Hand Conditions

Question 1

which condition causes an outpouching of synovial fluid from DIP joint?

Answer 1

mucous cyst

Question 2

why do you get outpouching of fluid in the DIP joint?

Answer 2

it is very small so there is nowhere for the fluid to go

Question 3

what are nail changes caused by a mucous cyst?

Answer 3

nail ridges

Question 4

treatment for a mucous cyst?

Answer 4

left alone

excision

Question 5

why are ganglions most common on the wrist?

Answer 5

they occur in synovial cavities so will be prominent in places with a high conc of synovial joints

Question 6

what is contained in a ganglion?

Answer 6

synovial fluid

Question 7

are ganglions or mucous cysts painful?

Answer 7

mucous cysts

Question 8

treatment for ganglions?

Answer 8

will resolve over time

Question 9

do ganglions stay constantly or come and go?

Answer 9

come and go

Question 10

management of ganglions?

Answer 10

aspiration

excision

Question 11

what does the flexor tendon sheath do?

Answer 11

holds tendons on to bone rather than letting them bowstring

Question 12

clinical presentation of trigger finger?

Answer 12

patient cant bend finger, cant extend it then it just triggers

Question 13

how do dupuytrens and trigger finger differ in presentation?

Answer 13

trigger finger will move

dupuytrens doesnt

Question 14

how to examine if a patient does/doesnt have trigger finger?

Answer 14

feel over nodule and get them to move finger, if sore over nodule its trigger finger

Question 15

pathology of trigger finger?

Answer 15

swollen tendon = irritation
tendon gets caught on edge of A1 pulley
triggering starts

Question 16

what happens to a severe trigger finger?

Answer 16

may need to use other hand to extend the finger or cant extend it at all

Question 17

management of trigger finger?

Answer 17

leave it
splint to prevent flexion
injected steroid
surgery to divide A1 pulley

Question 18

where should you inject steroids for trigger finger?

Answer 18

base of finger between tendon and fibrous sheath

Question 19

what pulley is essential for finger function?

Answer 19

A2

Question 20

is dequervains tenosynovitis painful?

Answer 20

yes

Question 21

treatment for dequervains?

Answer 21

NSAIDs
splint
rest
steroid injection
decompression surgery

Question 22

what does dupuytrens start as?

Answer 22

palmar pit/nodule

Question 23

causes of dupuytrens

Answer 23

genetics
alcohol/cirrhosis
smoking
epilepsy
diabetes

Question 24

examination of dupuytrens?

Answer 24

feel cords
MCP/PIP joint involvement
table top test

Question 25

treatment for dupuytrens?

Answer 25

stretches
fasciectomies
amputation
collagenase injection

Question 26

pathology of dupuytrens?

Answer 26

metaplasia of aponeurosis which causes fibroblasts to turn into myofibroblasts causing them to contract

Question 27

what does the aponeurosis of the palm do?

Answer 27

stops palm moving around eg when gripping it stops skin sliding over palm

Question 28

what is paronychia

Answer 28

infection within nail fold

Question 29

who gets paronychia?

Answer 29

children

Question 30

causative factors of paronychia?

Answer 30

nail biting

Question 31

management of paronychia

Answer 31

antibiotics
elevate
incise and drain pus

Question 32

is a flexor tendon sheath infection common?

Answer 32

no

Question 33

is a flexor tendon sheath infection a surgical emergency?

Answer 33

yes

Question 34

where can a flexor tendon sheath infection go?

Answer 34

palm then arm

Question 35

what tendons run in the digit?

Answer 35

FDS

FDP

Question 36

why would a dupuytrens contracture reoccur after treatment?

Answer 36

some myofibroblasts are left over

Question 37

why should you check the lymph nodes of the arm in flexor tendon sheath infection?

Answer 37

to see if infection has spread there