Finger/Hand Signs Flashcards

1
Q

What is Dupuytren contracture?

A

Progressive fibroplasia of the palmar fascia resulting in a flexion contracture of the fingers

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2
Q

Which fingers does Dupuytren contracture most commonly affect?

A

Ring and little fingers

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3
Q

Risk factors for Dupuytren contracture?

A
Male
Family history of it
Diabetes!
Alcoholic cirrhosis!
Phenytoin use (epileptic)
Trauma
AIDS!

More rare:
Peyronie disease
Ledderhose disease

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4
Q

Dupuytren contracture presentation on examination?

A

Thickened palmar aponeurosis is palpable

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5
Q

Treatment for Dupuytren contracture?

A

Excision of the thickened part of the aponeurosis

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6
Q

What is “trigger finger”?

A

Difficulty in extension of the finger caused by disparity in size between flexor tendon sheath and the tendon within it
- finger remains flexed until passively extended with a “click”

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7
Q

Is there association of alcohol excess with incidence of trigger finger?

A

No association with alcohol excess (much more likely to be Dupuytren contracture if so)

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8
Q

What is “asterixis”?

A

A jerking flexion-extension movement of the hand seen when arms are placed in an outstretched position with the wrists cocked back
- “liver flap”

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9
Q

What condition is asterixis associated with?

A

Hepatic encephalopathy

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10
Q

When should asterixis be tested for?

A

In all patients with liver disease who present with:

  • an acute deterioration of disease
  • worsening ascites
  • confusion
  • agitation
  • reversal of sleeping pattern
  • stupor

If positive alongside these then liver encephalopathy strongly suggested

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