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Abs MSK > Hand conditions > Flashcards

Hand conditions Flashcards

1
Q

What is Dupuytrens contracture

A

thickening and contracture of subdermal fascia leading to flexion deformity of the fingers

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2
Q

non-pathological fibres in Dupuytrens

A

bands

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3
Q

pathological fibres in Dupuytrens

A

cords

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4
Q

pathology of dupuytrens

A

proliferation of myofibroblasts and production of abnormal collagen (type 3 instead of type 1)

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5
Q

how does dupuytrens usually start

A

as a palmar pit or nodule

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6
Q

most commonly affected fingers in dupuytrens

A

ring and little fingers

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7
Q

risk factors of dupuytrens

A 
male 
scandanavian
family history 
alcoholic liver disease 
phenytoin therapy 
diabetes
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8
Q

Other fibromatoses which may occur in conjunction with dupuytrens

A

Peyronies disease in the penis

Ledderhose disease in the feet

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9
Q

what degree of contracture can be tolerated at the MCPj

A

30 degrees

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10
Q

surgical intervention of dupuytrens

A

fasciectomy (removes diseased tissue) or fasciotomy (divides cords)

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11
Q

newer treatments for dupuytrens

A

collagenase injections and percutaneous needle fasciotomy

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12
Q

what is trigger finger

A

when a swelling on a tendon causes it to be caught on the edge of the pulley (usually A1)

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13
Q

features of trigger finger

A

notable click may be heard before the finger flexes into a locked position, requiring manipulation to regain extension

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14
Q

most common fingers affected by trigger finger

A

middle and ring

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15
Q

treatment of trigger finger

A

tendon sheath injection with steroid and local anaesthetic

surgical division of the A1 pulley

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16
Q

Heberdens nodes

A

bony thickening of DIPJ seen in OA

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17
Q

Bouchard nodes

A

bony thickening of PIPJ seen in OA

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18
Q

treatment OA in hands

A

removal of osteophytes, excision of cysts, arthrodesis if severe

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19
Q

common thumb joint affected by OA

A

1st CMC

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20
Q

Joints which tend to be spared in RA

A

DIPs

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21
Q

disease progress in RA

A

synovitis and tenosyovitis
erosions of the joint
joint instability and tendon rupture

22
Q

deformities seen in RA

A

volar MCPj subluxation
ulnar deviation
swan neck deformity
boutonniere deformity

23
Q

what is a swan neck deformity

A

hyperextension at PIP with flexion at DIP

24
Q

what is a boutonniere deformity

A

flexion at PIP with hyperextension at DIP

25
Q

what is a ganglion cyst

A

outpouching of the synovial cavity

26
Q

features of ganglion cysts

A

firm, smooth and rubbery and should transilluminate

27
Q

what can cause ganglion cysts

A

partial tears during spraining

28
Q

treatment of ganglion cysts

A

percutaneous rupture

surgical excision

29
Q

what is the 2nd most common soft tissue swelling of the hand

A

giant cell tumour of the tendon sheath

30
Q

where are giant cell tumours usually found

A

palmar surface, especially around the PIP joint of the index and middle fingers

31
Q

features of giant cell tumours

A

well circumscribed, may or may not cause pain

32
Q

histological features of giant cell tumours

A

multinucleated giant cells and haemosiderin

33
Q

treatment of giant cell tumours

A

excision

34
Q

what is a mucous cyst

A

outpouching of the synovial fluid from the DIPj

35
Q

with what condition are mucous cysts associated with

A

OA

36
Q

what is dequervains tenosynovitis

A

spontaneous, painful condition of the tendons of the thumb side of the wrist
presents swollen and red

37
Q

test for dequervains tenosynovitis

A

finklesteins test - grip thumb in fist and ulnar deviate which causes pain

38
Q

management of dequervains tenosynovitis

A

NSAIDs, splinting and rest
steroid injections
decompressive surgery

39
Q

what is paronychia

A

infection within the nail fold, common in children

40
Q

what increases the risk of paronychia

A

nail biting

41
Q

management of paronychia

A

elevation, antibiotics and incision with drainage

42
Q

features of flexor tendon sheath infection

A

infection starts at sheath then tracks up palm and arm
extremely painful
limited extension
tracking lymphangitis

43
Q

management of flexor tendon sheath infection

A

surgical emergency

washout of tendon sheath

44
Q

what is a subungal haematoma

A

bruise under the nail

45
Q

treatment of subungal haematoma

A

trephine - heated paperclip melts through nail and relieves pressure

46
Q

type 1 nailbed injury

A

soft tissue only

47
Q

type 2 nailbed injury

A

soft tissue and nail

48
Q

type 3 nailbed injury

A

soft tissue and nail and bone

49
Q

type 4 nailbed injury

A

proximal 1/3 of phalanx

50
Q

type 5 nailbed injury

A

proximal to DIPj

51
Q

how to reduce a PIPj dislocation

A

pull it

52
Q

what is a bennetts fracture

A

extensor tendon of the thumb pulls the thumb downwards as the fracture means it is not attached to the rest of the hand
fracture subluxation

Abs MSK (14 decks)

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