Wrist and Hand Pathology & Special Tests Flashcards
Rheumatoid arthritis symptoms
inflammation of small joints, pain is symmetrical, morning stiffness greater than 1 hour
Rheumatoid arthritis special tests
-Observation of erythema and swelling multiple joints
-Progressive loss of Rom with change in biomechanics
osteoarthritis symptoms
-Pain increases with movement and improves with rest
-Morning stiffness less than 1 hour
-Reduced ROM of examination
-Crepitus may be present
-Bouchard’s and Heberden’s nodes (calcification)
Osteoarthritis special tests
-First CMC grind test
-Lever test
-MCP extension test
-Thumb ADD maneuver
-Thumb Exten maneuver
-Pain with ROM
volar plate injury (jammed finger) symptoms
-Pain
-Catching
-Localized bruising and swelling
-Hyperextension deformity > 15 degrees
volar plate injury (jammed finger) special tests
-Pain on palpation
-Hyperextension present
rupture of terminal phalangeal flexor (jersey finger) symptoms
-Pain
-Loss of DIP active flexion
-Swelling
rupture of terminal phalangeal flexor (jersey finger) special tests
-Pain on palpation
-Isolate DIP flexion, if ruptured, no contraction
Mallet finger (baseball finger)
-Pain distal phalanx
-Swelling
-Deformity (DIP in flexion)
Mallet finger (baseball finger) special tests
-Pain on palpation
-Isolate DIP extension, if ruptured, no contraction
Dequervain’s tenosynovitis
-Pain radial wrist
-Tenderness APL, EPB
-Swelling
Dequervain’s tenosynovitis special tests
-Palpation pain
-Pain on contraction
-Eichoff test
-Wrist hyperflexion and ABD test
-Finkelstein test
Ulnar nerve entrapment
-Pain and/ or paresthesias ulnar nerve distribution distal to Tunnel of Guyon
Ulnar nerve entrapment special tests
- Tinel sign
- Decreased sensation
ulnar N. distribution
acute carpal tunnel syndrome
- Paresthesia with repetitive finger motions (typing)
- Numbness median nerve distribution at night
- Symptoms decrease with shaking hands
subacute carpal tunnel syndrome
- Paresthesia
- Weakness with fine motor activities
chronic carpal tunnel syndrome
- Muscle wasting thenar eminence
carpal tunnel syndrome special tests
-Phalens
-Reverse Phalens
-Carpal compression
-Wrist ratio (>.67)
-Sensory loss median nerve distribution
-CTQ-SSS >1.9
-Grip Strength
TFCC tear
-Pain ulnar side of wrist – can be very diffuse
-May have popping/ clicking/ catching with pro/supination
-Pain with power grip
TFCC tear special tests
-Hypersupination painful
-Press test
scaphoid fracture symptoms
-Pain radial side of wrist
-Pain with loading of UE (weight bearing)
scaphoid fracture special tests
-Snuff box tenderness on palpation
-Scaphoid compression tenderness
- pain with resisted supination
-Scaphoid fracture test
phalangeal fractures
-Pain at fracture location
-Swelling and discoloration
-Pain with movement
-Deformity may be present if displaced
phalangeal fractures special tests
-Pain with palpation
-Pain with compression
