Non arthritic hand conditions Flashcards
management of ganglion cysts
- Usually resolve with time but excision may be required for localised discomfort or cosmoses
- Needle aspiration may be attempted but recurrence is common
are ganglion cysts painful
no but may feel tight
what is carpal tunnel syndrome due to
compression of the carpal tunnel ligament on the median nerve
what are the causes of carpal tunnel
- Mostly idiopathic
- Can occur secondary to many conditions
- RA - synovitis means less space
- Acromegaly
- Conditions resulting in fluid retention e.g. pregnancy, diabetes, chronic renal failure, hypothyroidism
- In pregnancy the symptoms usually subside after birth
- Can be a consequence of fractures around the wrist
- Women affected up to 8x more than men
where does the median nerve supply sensory innervation to
palmar aspect of hand, thumb, index, middle and radial half of ring finger
what is a mucous cyst
outpocuhing of synovial fluid from distal interphalangeal joint due to osteoarthirtis
is a mucous cyst painful
yes it may be
management of ganglion cysts
aspiration
excision
neglect
what might happen over time with a mucous cysts
- Initially quite small but can increase in size and cause thinning of the skin
- If the skin becomes very thin it can rupture and produce discharge
- If it becomes particularly large it can deform the nail and cause a ridge
management of mucous cyst
- May be left alone - majority of cysts will completely disappear over time
- In patients with particularly deep/cracked nail ridges, or those who are constantly discharging, consider excision
- Often needs advancement/rotation flap if larger
what is trigger finger
Inhibition of smooth tendon gliding due to mechanical impingement at the level of the A1 pulley that causes progressive pain, clicking catching and locking of the affected finger
so finger gets locked in flexed position
what group of people is trigger finger more common in
women
over 50s
diabetics
management of trigger finger
- Often resolves spontaneously
- Splint to prevent flexion
Tendon sheath injection
- Steroid + LA
- Often curative
- May be repeated 2x
Surgical release
- Division of the A1 pulley under general or local anaesthetic
what does dequervains affect
the tendons on the thumb side of your wrist
what is dequervains
inflammation of the tendon sheats of the thumb
