Hand Flashcards
What is trigger finger?
Tendonitis of any. of the flexor tendons?
What are signs of trigger finger?
Finger locks in flexed position.
Finger may click when moved.
May have to forcibly manipulate finger to regain movement.
Which fingers are most commonly affected in trigger finger?
Middle and wring finger
Which is the usual fascial pulley affected in trigger finger?
A1
What is the most common treatment for trigger finger?
Steroid injections- usually relieve symptoms.
If symptoms of trigger finger persist what is the treatment?
surgical incision if the pulley, division if A1 has no effect on function.
Heberdens nodes
On the DIP bony thickenings
Osteoarthritis
Bouchards nodes
On the PIP bony swelling
Linked to osteoarthritis.
If there is OA in the MCP joint what is most likely to have occurred?
Previous injury
occupational stress
Gout
Infection
Common sign in OA of the 1t carports-metacarpal joint (base of the thumb)
Squaring of the thumb base
Where on the hand in contrast to OA and psoriatic arthritis is spared?
The DIP Distal Interpharangeal Joint
What are the three stages of RA in the hands?
Synovitis and Tenosynovitis
Erosion of the joint
Joint instability and tendon rupture.
Why are late stage presentations far less common now?
Introduction of DMARDs has reduced the prevalence.
What procedure may prevent tendon rupture?
Tenosynovectomy
- excision of the synovial sheath
Why is it important to prevent tendon rupture in RA?
As the tendon is too diseased to be repaired by direct surgery.
Tendon transfers or joint fusions are the only option to preserve function.
Ganglion cyst
Common mucinous filled cyst adjacent to a tendon of a synovial joint.
What is the common appearance of a ganglion cyst?
Firm
Smooth
Rubbery
Transilluminate
What are main reasons for removal of a cyst?
Pain and localised discomfort
Cosmetic - isn’t always supplied by NHS
Arguments against removal of a ganglion cyst?
If for cosmetic reasons you are swapping a cyst for a scar - still not cosmetically pleasing and often tender.
