Hand Examination Flashcards
What are the five stages of a hand examination?
Inspection, palpation, assess range of motion, test function, special test
What do you inspect on inspection?
Nails, fingers, palm and dorsum of the hand, wrist and elbow
What 5 things do you look for in the nails?
Putting and/or nail ridges, onycholysis, onychogryphosis, splinter haemorrhages, clubbing
Why do you get putting in the nails?
Psoriasis
What is onycholysis?
Separation of the nail from the nail bed
What causes onycholysis
Psoriasis, fungal infection, hyperthyroidism
What is onychogryphosis?
Hypertrophic nails that resemble horns or claws
What causes onychogryphosis?
May be post-traumatic or due to peripheral vascular disease
What 10 things do you look for in the fingers?
Colour, scars, skin changes, trophic changes, swelling, nodular deformities, finger deformities, squaring of the hand, windswept deformity, abnormal posturing
What skin changes do you look for in a patients fingers?
Sclerodactyly (thickening and tethering of skin over fingers/more proximal)
What trophic changes do you look for in their fingers?
Ulcers, pulp atrophy due to neuropathies or severe Raynaud’s
What fusiform or focal swelling do you look for?
Dactylitis of psoriatic arthritis and the arthropathies associated with ankylosing spondylitis or IBD
What nodular deformities do you get with osteoarthritis?
Bouchard’s nodes at the PIPJs and Heberden’s notes at the DIPJs
What deformities do you get in rheumatoid arthritis ?
Swan neck and Boutonnière deformities
Why do you get squaring of the hands?
At the 1st carpometacarpal joint in osteoarthritis
