Non Arthritic Hand Conditions Flashcards

1
Q

what is a mucous cyst

A

outpouching of synovial fluid from DIPjt OA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are the features of a mucous cyst

A

can be painful, may fluctuate/ discharge, may deform nail, cause ridge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is the treatment for a mucous cyst

A

can be left alone

excision (take down to bone as there may be a small osteophyte)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what can happen if an excised mucous cyst recurs

A

can damage nail bed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what are ganglions

A

outpouching of synovial cavity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what are the features of ganglions

A
more common where high concentration of synovial joints,
filled with synovial fluid,
fluctuate,
usually painless, 
may feel tight,
resolve with time
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

how can you treat ganglions

A

most resolve with time but can aspirate with large bore (thick fluid) needle, or excision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are the risks of treating ganglion

A

50% recurrence rate

volar wrist ganglion on radial artery so not safe to aspirate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what do the flexor tendons in the hand run in

A

the flexor tendon sheath

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what causes trigger finger

A

any swelling on a tendon leads to irritation (e.g nodule due to microtrauma) = more swelling= tendon gets caught on edge on A1 pulley= pain over A1 pulley (MC head)= sticking of finger (usually in flexion)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is the purpose of the flexor tendon sheath

A

holds the tendons to the bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

who is at higher risk of trigger finger

A

diabetics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are the examination findings of trigger finger

A

demonstrate triggering, tender over A1 pulley, feel nodule pass beneath pulley

important to distinguish form dupuytrens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

how do you manage trigger finger

A

conservative- often resolves spontaneously, splint to prevent flexion

tendon sheath injection- steroid + LA, often curative, done up to 3 times

surgery- under GA/ LA, divide A1 pulley

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is dequervains tenosynovitis

A

irritation of the tendon sheath holding the radial tendons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are the features of dequervains

A

spontaneous, painful (on thumb extension), swollen/red, locally tender, finklesteins test (grab thumb with folded fingers then ulnar deviate)

17
Q

what is the management for DeQuervains

A

NSAIDs, splint, rest, steroid injection, surgery (decompression- open tendon sheath)

18
Q

what is dupuytrens contracture

A

thickening and contractuyre of subdermal fascia leading to fixed flexion deformity of fingers

19
Q

what are the features of dupuytrens

A

painless, gradual progression, usually starts as palmar pit/ nodule, more common in men- more aggressive in women

20
Q

what is the cause of dupuytrens

A

unknown, associated with;

  • genetics
  • diabetes
  • alcohol/ cirrhosis
  • smoking
  • injury
  • peyronies (penis)
21
Q

what is seen on examination of dupuytrens

A

feel cords, MCP/PIP involvement (MCP corrects easily), table top test) hand flat on table)

22
Q

what is the treatment for dupuytrens

A

conservative- stretches, activity modification

surgery- segmental fasciectomy, dermofasciectomy, amputation

new treatments- collagenase injection, percutaneous needle fasciotomy

23
Q

what is paronychia

A

infection within the nail fold, may result in pus collection

24
Q

who gets paronychia

A

often children- nail biting is a risk for it

25
how do you manage paronychia
elevate, antibiotics, incise and drain pus collection
26
is flexor tendon sheath infection self limiting
no surgical emergency- if dont treat quickly will get permanent contracture
27
what are the features of flexor tendon sheath infectino
rare, infection within sheath + tracking up palm arm, extremely painful, limited extension (including passive) due to pain, may have tracking lymphangitis, usually unwellm erythema tracks
28
how do you treat flexor tendon sheath infection
wash out the tendon