Lecture 9: Elbow, Wrist, and Hand Complaint Flashcards
What ranges of motions are you checking for elbow?
What muscles contribute to these ROM?
Flexion: Biceps brachii, Brachialis, Brachioradialis
Extension: Triceps brachii, Anconeus
Pronation: Pronator Teres and Pronator Quadratus
Supination: Biceps Brachii and Supinator
What are some common causes of elbow pain?
- Gout
- Lateral Epicondylitis
- Medial Epicondylitis
- Cubital Tunnel Snydrome
- Olecranon Bursitis
What does a valgus stress test indicate?
Sprained medial (ulnar) collateral ligament
Elbow toward body and forearm goes away
What does a varus stress test indicate?
Sprained lateral (radial) collateral ligament
Elbow away from body and forearm toward body
What does a Tinel test indicate?
Ulnar Nerve Entrapment (Cubital Tunnel Syndrome)
What does Golfer’s Elbow indicate?
Medial Epicondylitis
- Pain aggravated by resisted wrist flexion
- Microtears or microavulsions in common flexor tendons
What does Tennis Elbow indicate?
Lateral Epicondylitis
- Pain aggravated by resisted wrist extension
- Microtears or microavulsions in common extensor tendons
What is Olecranon Bursitis?
Trauma in elbow that can have inflammatory or infectious etiologies
Septic or aseptic
What range of motions are you checking in the wrist?
Flexion and Extension
Abudction and Adduction
What does Phalen’s Sign indicate?
Carpal Tunnel Syndrome
-Compression of Median nerve
What does Tinel’s Sign indicate?
Carpal Tunnel Syndrome
-Compression of Median nerve
What does Finkelstein Test indicate?
de Quervain’s Tenosynovitis
-Inflammation of tendon and synovial sheath covering Extensor Pollicis Brevis and Abductor Pollicis Longus
What is Rheumatoid Arthritis?
Autoimmune disorder characterized by symmetric joint pain, swelling, and stiffness in joints
- mostly in wrists, MCP, and PIP joints
- pain improves with activity
What is Felty Syndrome?
“Super Rheumatoid’’ Disease characterized by:
- Severe Rheumatoid Arthritis
- Splenomegaly
- Neutropenia (susceptibility to bacterial infections)
What lab tests can indicate Rheumatoid Arthritis?
- Rheumatoid Factor
- Anticyclic citrullinated peptide (Anti-CCP) antibodies
How would you treat Rheumatoid Arthritis?
- anti-TNF alpha drugs
- T cell inhibitors
- Traditional Drugs (e.g. Methotrexate)
What is a Boutonniere Deformity?
PIP flexion and DIP hyperextension
What is a Swan Neck Deformity?
PIP hyperextension and DIP flexion
Will you tend to see ulnar or radial deviation with Rheumatoid Arthritis?
Ulnar deviation
What is osteoarthritis?
Gradual onset of asymmetric joint pain and stiffness
- Commonly seen in DIP, PIP, and 1st carpometacarpal joint
- Pain worsens with activity and relieved with rest
- Joint stiffness lasts less than an hour and improves with activity
What are Heberden’s nodes?
Swelling at DIP joints
Asscoiated with Osteoarthritis
What are Bouchard’s nodes?
Swelling at PIP joints
Asscoiated with Osteoarthritis
What is a ganglion cyst?
Potentially painful yet smooth/firm rubbery cystic lesion that can be normally seen on wrist (dorsal and palmar) as well as over fingers
-thought to arise from herniation of connective tissue
What is a scaphoid (navicular) fracture?
Wrist pain on radial aspect, especially in anatomic snuff box
-Normally seen in patients who Fall On an Outstretched Hand (FOOSH)
What is Colle’s Fracture?
Distal wrist pain
-also seen FOOSH patients
What is a Trigger finger?
Pain, stiffness, and a sensation of locking or catching when you bend and straighten your finger
-mostly seen in ring finger or thumb
What is Dupuytren’s Contracture?
Progressive fibrosis of palmar fascia, which results in gradual joint stiffness and inability to extend the finger
