elbow, wrist and hand conditions Flashcards
is lateral epicondylitis also known as tennis or golfer’s elbow
tennis
is medial epicondylitis also known as tennis or golfer’s elbow
golfer’s
what is lateral epicondylitis
inflammation of the common extensor tendon as a result of repetitive strain
lateral epicondylitis presentation
- pain on elbow movement
- history of repetitive use in occupation/hobbies
- tenderness over local epicondyle and pain on resisted extension of wrist and fingers
lateral epicondylitis diagnosis
clinical
lateral epicondylitis management
self limiting (rest, ice, NSAIDs, brace and physiotherapy)
what is medical epicondylitis
inflammation of the common flexor tendon as a result of repetitive strain
medial epicondylitis presentation
- pain on elbow movement
- history of repetitive use in occupation/hobbies
- tenderness over medial epicondyle and pain on pronation/wrist flexion
medial epicondylitis diagnosis
clinical
medial epicondylitis management
self limiting (rest, ice, NSAIDs, brace and physiotherapy)
Dupuytren’s contracture is more common in
men
Dupuytren’s contracture causes
- idiopathic
- familial
- alcohol
- diabetes
- anti-epileptics
Dupuytren’s contracture pathophysiology
- progressive, painless, fibrotic thickening and contracture of the palmar aponeurosis of the hand
- results in the development of fascial nodules and cord, and contracture of the fingers
- contracture initially starts with flexion of MCP joints and then flexion of IP joints
Dupuytren’s contracture presentation
- visible contraction of fingers
- puckering and tethering of the skin
- usually symmetrical and bilateral, and most commonly affects ring and pinkie fingers
- palpable nodules and positive tabletop test
Dupuytren’s contracture management
- depends on degree of finger contraction and level of disability it creates
- do nothing
- fasciotomy or fascia removal (risk of reccurence)
- finger amputation
trigger finger pathophysiology
- thickened portions of the flexor tendon sheaths
- caused by nodular enlargement of a flexor tendon distal to the A1 pulley due to tendonitis
- when the finger is flexed, the nodule will move proximal to the pulley but when extended there will be a trigger sensation as the nodules moves back under the A1 pulley
trigger finger presentation
- clicking sensation when extending the finger
- pain on extension of the finger
- finger being stuck in a flexed position
- most commonly affects middle and ring fingers
trigger finger management
- immobilisation or steroid injection
- incision and separation of the A1 pulley
what is a ganglia
mucous filled cysts that are found adjacent to a tendon or synovial joint
ganglia presentation
- lump at wrist or at flexor tendons
- localised pain
ganglia management
- leave alone as they can spontaneously resolve
- needle drainage
- surgical excision
what is Dequiveren’s tenosynovitis
inflammation of the tendons of extensor pollicis brevis and abductor pollicis longus as they pass over the styloid process of the radius and through the anatomical snuffbox
Dequiveren’s tenosynovitis cause
thought to arise due to repetitive strain and can result in stenosis of the tendons
Dequiveren’s tenosynovitis presentation
- swelling on radial aspect of wrist
- pain on lifting objects with hands, wrist flexion and abduction
- Finkelstein’s positive
Dequiveren’s tenosynovitis management
- 1st line: spica thumb splint, rest and NSAIDs
- 2nd line: steroid injections
