Non arthritic hand conditions Flashcards
What is a mucous cyst?
Outouching of synovial fluid from DIPjt OA
may be painful, have discharge, may deform nail and cause ridge
Tx for mucous cyst
may be left alone
excision
What is a ganglion?
out-touching of synovial cavity (therefore more common where high concentration of synovial joints e.g. wrists)
What is a ganglion filled with
synovial fluid
Ganglion- fluctuation, pain?
fluctuates
usually painless but may feel tight
What is ganglion management
Perfer to leave because they fluctuate so much
“family bible”
aspiration
excision
What is Trigger finger
Pain over A1 pulley (MC head)
“Triggering”-sticking of finger(usually in flexion)
What do tendons run in?
flexor tendon sheath
Any swelling on a tendon leads to ….. and more irritation leads to more …..
irritation
swelling
What is found OE of trigger finger
Demonstrate triggering
tendon over A1 pulley
feel nodule pass beneath pulley
Trigger finger Management ( 3 options)
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
What happens if you divide more than one pulley ( e.g. divide A2 aswell)?
Bowstring
What is the test for DeQuervains?
Make hand into a fist and and the examiner pulls ti away . Should be v painful
What is DeQuervains?
inflammation of tendons on the side of the wrist at the base of the thumb.
Spontaneous,painful, swollen/red
What is the possible treatment for DeQuervains?
NSAIDs splint rest steroid injection surgery-decompression
What does dupuytrens contracture usually start as?
palmar pit/nodule
What is dupuytrens contracture called when it is in the feet and the penis
Feet- Lederhosen’s
Penis-Peyronie’s
Dupytrens has a 10% rate of recurrence T/F
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
What is paronychia
Infection within nail fold
often in children
risk-nail biting
may result in pus collection
Management of paronychia
elevate
antibiotics
incise and drain collection
What is Flexor tendon sheath infection
rare but surgical emergency
spontaneous excruciating pain
infection within sheath, tracking up palm and arm
What is the management of flexor tendon sheath infection
wash out tendon sheath
