UE Diagnostic Manual - MPD at Wrist/Hand

Question 1

what is the most common muscle power deficit at the wrist/hand

Answer 1

DeQuervain’s tendonitis

Question 2

outcome measures for MPD at w/h

Answer 2

PSFS
DASH
Quick DASH
Patient Rated Wrist Eval

Question 3

diagnostic information related to DeQuervain’s tendonitis

Answer 3

inflammation/irritation of Extensor Policis Brevis and Abductor Policis Longus

typically precipitated by overuse or direct trauma to radial styloid

Question 4

ROM finding related to wrist/hand muscle power deficit

Answer 4

limited thumb ROM / wrist ulnar dev

pain present with active extension/abduction of thumb (>if resisted)

pain with opposition (stx)

Question 5

muscle performance finding related to wrist/hand muscle power deficit

Answer 5

diminished grip and pinch strength
APL and/or EPB manual resistive test
–> weak and painful

Question 6

palpation finding related to wrist/hand muscle power deficit

Answer 6

tenderness of APL and/or EPB tendon

Question 7

joint mobility finding related to wrist/hand muscle power deficit

Answer 7

normal/unremarkable

Question 8

neuro finding related to wrist/hand muscle power deficit

Answer 8

n/a - normal

Question 9

special test related to wrist/hand muscle power deficit

Answer 9

finkelstein’s test

Question 10

what is important for patient education intervention

Answer 10

rest and use of contralateral hand
– due to repetitive nature of condition’s onset

Question 11

physical therapy interventions for MPD at w/h

Answer 11

restoring ROM as tolerated
progressive strengthening without repetitive pinching
– isometrics early, as tolerated
– functional training when symptoms reduce

Question 12

medical interventions for MPD at w/h

Answer 12

oral anti-inflammatories
spica splinting (based upon severity)
surgical release of 1st dorsal compartment