non-arthritic hand conditions

Question 1

what is a mucous cyst?

Answer 1

outpouching of synovial fluid from DIPJs in osetoarthritis

Question 2

what are the symptoms of mucous cysts?

Answer 2

pain, fluctuating cyst, can have discharge, can cause nail ridge

Question 3

what is the treatment of mucous cysts

Answer 3

usually resolves on its own, if not surgery

Question 4

what are ganglions?

Answer 4

outpouchings of synovial fluid seen over synovial joints

Question 5

symptoms of ganglions?

Answer 5

usually painless but can be tight

Question 6

what is the treatment of ganglions?

Answer 6

usually resolve on their own but can be excised if pateint is concerned although there is infection risk

Question 7

describe trigger finger

Answer 7

tendons swell causing them to get caught on A1 pulley, causing pain on use of finger

Question 8

what are examination findings of trigger finger?

Answer 8

nodule passing beneath pulley, triggering and tenderness

Question 9

what is the management of trigger finger?

Answer 9

conservative- splint
steroid injections
surgery to divide A1 pulley

Question 10

what 9 tendons are in the carpal tunnel?

Answer 10

4x flexor digitorum profundus
4x flexor digitorum superficialis
1x flexor pollicis longus

Question 11

what are the symptoms of carpal tunnel syndrome?

Answer 11

pain worse at night relieved by shaking the hand, sensory involvement to radial 3 1/2 fingers, palmar sensation is often spared

Question 12

what is the manaegment of carpal tunnel syndrome?

Answer 12

splint
diagnostic steroid injection
surgery (carpal tunnel release- divides transverse carpal ligament)

Question 13

what is De Quervain’s tenosynovitis?

Answer 13

inflammatiom within tendon sheath of first extensor compartment. can cause pain, redness and swelling.
do finklestein and eichoff’s tests.

Question 14

how do you manage De Quervain’s tenosynovitis?

Answer 14

can settle on its own
NSAIDs
splint
rest
steroid injections
surgery

Question 15

what is Dupuytren’s contracture?

Answer 15

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

Question 16

what do you examine for Dupuytren’s contracture?

Answer 16

feel chords, MCP / PIP joint involvement, measure angles, tabletop test

Question 17

how do you manage Dupuytren’s contracture?

Answer 17

stretches and activity modification
surgery- very invasive fasciotomies, may require skin grafts

Question 18

what is a paronychia?

Answer 18

infection within nail fold, caused by nail biting - the red pus filled skin around nails that children get

Question 19

what is the management for paronychia?

Answer 19

elevate, drain, antibiotics

Question 20

what is a flexor tendon sheath infection?

Answer 20

infection within sheath that tracks up palm and arm- rare but important as it is a surgical emergency

Question 21

what are the symptoms of flexor tendon sheath infection?

Answer 21

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

Question 22

what is the management of flexor tendon sheath infection?

Answer 22

wash put tendon sheath- A1- A5 pulleys

Question 23

what does LOAF stand for?

Answer 23

lumbricals IF and MF
opponens pollicis
abductor pollicis brevis
flexor pollicis brevis

Question 24

what nerve is affected in carpal tunnel syndrome?

Answer 24

median nerve

Question 25

what nerve is affected in cubital tunnel syndrome?

Answer 25

ulnar nerve

Question 26

what are the symptoms of cubital tunnel syndrome?

Answer 26

early - ulnar pins & needles, pain, clumsiness
late - numbness & weakness
functional - night, leaning

Question 27

what muscles of the hand does the median nerve innervate

Answer 27

LOAF muscles

Question 28

what hand muscles does the ulnar nerve innervate

Answer 28

all except LOAF muscles

Question 29

what are the visible signs of cubital tunnel syndrome?

Answer 29

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

Question 30

what tests do you do for cubital tunnel?

Answer 30

Tinnel’s (t for tap)
Phalen’s (p for reverse prayer)
Froment’s test (thumb flexion during key grip)