non-arthritic hand conditions Flashcards
what is a mucous cyst?
outpouching of synovial fluid from DIPJs in osetoarthritis
what are the symptoms of mucous cysts?
pain, fluctuating cyst, can have discharge, can cause nail ridge
what is the treatment of mucous cysts
usually resolves on its own, if not surgery
what are ganglions?
outpouchings of synovial fluid seen over synovial joints
symptoms of ganglions?
usually painless but can be tight
what is the treatment of ganglions?
usually resolve on their own but can be excised if pateint is concerned although there is infection risk
describe trigger finger
tendons swell causing them to get caught on A1 pulley, causing pain on use of finger
what are examination findings of trigger finger?
nodule passing beneath pulley, triggering and tenderness
what is the management of trigger finger?
conservative- splint
steroid injections
surgery to divide A1 pulley
what 9 tendons are in the carpal tunnel?
4x flexor digitorum profundus
4x flexor digitorum superficialis
1x flexor pollicis longus
what are the symptoms of carpal tunnel syndrome?
pain worse at night relieved by shaking the hand, sensory involvement to radial 3 1/2 fingers, palmar sensation is often spared
what is the manaegment of carpal tunnel syndrome?
splint
diagnostic steroid injection
surgery (carpal tunnel release- divides transverse carpal ligament)
what is De Quervain’s tenosynovitis?
inflammatiom within tendon sheath of first extensor compartment. can cause pain, redness and swelling.
do finklestein and eichoff’s tests.
how do you manage De Quervain’s tenosynovitis?
can settle on its own
NSAIDs
splint
rest
steroid injections
surgery
what is Dupuytren’s contracture?
thickening and contracture of subdermal fascia leading to fixed flexion deformity of the fingers. (loose skin causes over flexion of tendons causing difficulty to hold things)
it is painless and gradually progresses
what do you examine for Dupuytren’s contracture?
feel chords, MCP / PIP joint involvement, measure angles, tabletop test
how do you manage Dupuytren’s contracture?
stretches and activity modification
surgery- very invasive fasciotomies, may require skin grafts
what is a paronychia?
infection within nail fold, caused by nail biting - the red pus filled skin around nails that children get
what is the management for paronychia?
elevate, drain, antibiotics
what is a flexor tendon sheath infection?
infection within sheath that tracks up palm and arm- rare but important as it is a surgical emergency
what are the symptoms of flexor tendon sheath infection?
extreme pain and limited extension
large swollen red finger that runs in a line down hand and into wrist and arm
painful to percuss
affected finger held in fixed flexion
what is the management of flexor tendon sheath infection?
wash put tendon sheath- A1- A5 pulleys
what does LOAF stand for?
lumbricals IF and MF
opponens pollicis
abductor pollicis brevis
flexor pollicis brevis
what nerve is affected in carpal tunnel syndrome?
median nerve
what nerve is affected in cubital tunnel syndrome?
ulnar nerve
what are the symptoms of cubital tunnel syndrome?
early - ulnar pins & needles, pain, clumsiness
late - numbness & weakness
functional - night, leaning
what muscles of the hand does the median nerve innervate
LOAF muscles
what hand muscles does the ulnar nerve innervate
all except LOAF muscles
what are the visible signs of cubital tunnel syndrome?
hypothenar & interosseous atrophy
clawing of ring and 5th finger
altered sensation
weakness abducting digiti minimi
weakness of grasp and pinch
Wartenberg’s sign- abducted small finger
what tests do you do for cubital tunnel?
Tinnel’s (t for tap)
Phalen’s (p for reverse prayer)
Froment’s test (thumb flexion during key grip)
