Non arthritic hand conditions

Question 1

What is a mucous cyst?

Answer 1

Outouching of synovial fluid from DIPjt OA

may be painful, have discharge, may deform nail and cause ridge

Question 2

Tx for mucous cyst

Answer 2

may be left alone

excision

Question 3

What is a ganglion?

Answer 3

out-touching of synovial cavity (therefore more common where high concentration of synovial joints e.g. wrists)

Question 4

What is a ganglion filled with

Answer 4

synovial fluid

Question 5

Ganglion- fluctuation, pain?

Answer 5

fluctuates

usually painless but may feel tight

Question 6

What is ganglion management

Answer 6

Perfer to leave because they fluctuate so much
“family bible”
aspiration
excision

Question 7

What is Trigger finger

Answer 7

Pain over A1 pulley (MC head)

“Triggering”-sticking of finger(usually in flexion)

Question 8

What do tendons run in?

Answer 8

flexor tendon sheath

Question 9

Any swelling on a tendon leads to ….. and more irritation leads to more …..

Answer 9

irritation

swelling

Question 10

What is found OE of trigger finger

Answer 10

Demonstrate triggering
tendon over A1 pulley
feel nodule pass beneath pulley

Question 11

Trigger finger Management ( 3 options)

Answer 11

Conservative- splint to prevent flexion
tendon sheath injection-steroid +LA,often curative, may be repeated up to 3x
Surgery-under GA or LA, divide A1 pulley

Question 12

What happens if you divide more than one pulley ( e.g. divide A2 aswell)?

Answer 12

Bowstring

Question 13

What is the test for DeQuervains?

Answer 13

Make hand into a fist and and the examiner pulls ti away . Should be v painful

Question 14

What is DeQuervains?

Answer 14

inflammation of tendons on the side of the wrist at the base of the thumb.
Spontaneous,painful, swollen/red

Question 15

What is the possible treatment for DeQuervains?

Answer 15

NSAIDs
splint
rest
steroid injection
surgery-decompression

Question 16

What does dupuytrens contracture usually start as?

Answer 16

palmar pit/nodule

Question 17

What is dupuytrens contracture called when it is in the feet and the penis

Answer 17

Feet- Lederhosen’s

Penis-Peyronie’s

Question 18

Dupytrens has a 10% rate of recurrence T/F

Answer 18

F- dupytrens has a very high rate of recurrence as dupytrens is adhered to the skin so even after surgery there will always be some myofibroblasts left. can therefore remove skin and make a skin graft to reduce risk of recurrence

Question 19

What is paronychia

Answer 19

Infection within nail fold
often in children
risk-nail biting
may result in pus collection

Question 20

Management of paronychia

Answer 20

elevate
antibiotics
incise and drain collection

Question 21

What is Flexor tendon sheath infection

Answer 21

rare but surgical emergency
spontaneous excruciating pain
infection within sheath, tracking up palm and arm

Question 22

What is the management of flexor tendon sheath infection

Answer 22

wash out tendon sheath