hand pathologies Flashcards
What is OA?
Degenerative, wear and tear arthritis, the wearing away of the cartilage in the joint.
OA primarily affects the 1st CMC and DIP joints.
What are the signs and symptoms of OA in the CMC joint?
- Pain with activities involving gripping or pinching
- Swelling and tenderness at the base of the thumb
- Aching discomfort after prolonged use
- Loss of strength in gripping or pinching
- Enlarged, ‘out-of-joint’ appearance
- Development of a bony prominence
- Limited motion/stiffness
What is the carpal tunnel?
An archway at the wrist formed by carpal bones and covered by the flexor retinaculum, allowing extrinsic muscles to cross into the hand.
Contains nine tendons and the median nerve.
What is tenosynovitis?
Inflammation of the tendon sheath that can compress the median nerve against the transverse ligament.
Can be caused by pregnancy, RA, OA, repetitive wrist flexion, or post fractures.
What are the classic symptoms of carpal tunnel syndrome?
- Numbness
- Pins and needles
- Clumsiness in the affected hand
What is de Quervain disease?
A common pathology resulting in pain from resisted gliding of the APL and EPB tendons in the fibro-osseous canal.
Involves degenerative thickening of the extensor retinaculum.
What activities are linked to de Quervain’s disease?
- Golf
- Playing the piano
- Typing
- Carpentry
- Carrying a child
What is an ulnar collateral ligament injury?
Results from trauma or overstretching, causing instability of the 1st metacarpophalangeal joint.
Also known as gamekeeper’s thumb and skier’s thumb.
What are the signs of carpal instability?
- Pain over the ulnar aspect of the 1st MCP joint
- Bruising
- Tenderness
- Localized swelling
What is the triangular fibrocartilage complex (TFCC)?
Formed by the triangular fibrocartilage discus, radioulnar ligaments, and ulnocarpal ligaments, providing stability to the wrist joint.
Acts as a shock absorber and allows smooth wrist movement.
What are common symptoms of a TFCC injury?
- Ulnar sided wrist pain
- Clicking/snapping on rotation
- Unable to weight bear
- Swelling
- Tender dorsal aspect of the wrist
What is Dupuytren’s contracture?
A progressive condition affecting the palmar fascia, resulting in thickening and tightening that pulls fingers into flexion.
Treatment typically involves surgical intervention.
What is Complex Regional Pain Syndrome (CRPS)?
A chronic, debilitating pain condition usually affecting one limb after an injury or surgery, with pain severe and disproportionate to the original injury.
What are triggers for CRPS?
- Injury (e.g., fractures)
- Surgery (e.g., carpal tunnel release)
What are the main symptoms of CRPS?
- Chronic pain
- Allodynia
- Temperature and skin color changes
- Swelling
- Muscle weakness and limited motion
What are potential long-term complications of CRPS?
- Skin ulcers or infections
- Muscle wasting
- Muscle contractures
What are the treatment options for flexor tendon injuries?
- Full tear – surgical repair
- Partial tear – splinting and exercises
What types of injuries can cause flexor tendon injuries?
- Cuts with nerve injury
- Sports injuries (e.g., ‘jersey finger’)
- Strain or rupture from extreme gripping
What is the prognosis for CRPS?
Can improve over time for many, but some may endure long-term pain and disability.
