Wrist conditions Flashcards
Carpal tunnel syndrome
Carpal Tunnel Syndrome (CTS): CTS is a condition caused by compression of the median nerve as it travels through the carpal tunnel at the wrist. This can result in sensory symptoms such as pins and needles, as well as pain and weakness in the affected hand
-MC hand compression neuropathy of median nerve beneath the flexor retinaculum
-Common among office workers-intense computer use due to wear and tear pathophysiology
-3 to 10 times more common in women than men
-Peak age 45-60y/o and is bilateral in 50% of cases
-Causes: It can have local causes through inflammation, trauma,
tumour and anatomical anomalies. Regional causes through OA, RA and Gout or can be systemic through diabetes or pregnancy
-Symptoms: Sensory and motor changes causing weakness, loss of grip strength, atrophy pain and numbness and tingling localized to the palmar aspect of the First to the Fourth fingers and the distal palm.
De Quervain’s Tenosynovitis
-Inflammation of synovium surrounding a tendon, commonly a result of a local blow, unaccustomed overuse, Auto immune(RA) or infection
-Involves the abductor pollicis longus and extensor pollicis brevis
-Due to Synovial sheath being irritated by repetitive thumb
movement and pinching activities
-More common in middle aged women and common in sports that require repetitive forced grasp with ulnar deviation (Badminton, Golfers)
Ganglion cyst
Ganglion cysts of the wrist are fluid-filled sacs that form on or around the wrist joint or tendons. They are usually benign and do not require treatment
-A ganglion cyst is a tumour or swelling on top of a joint or the tendon sheath
-This type of cyst is not harmful and accounts for about half of all soft tissue tumours of the hand.
-The exact cause of ganglion cysts is unknown, may be caused by joint inflammation
-Ganglion cysts are more common in women than men
-70% of ganglion cysts occur in people between the ages of 20-40
The underlying pathology of ganglion cysts involves the formation of a sac or pouch filled with synovial fluid
-Most commonly they occur on the back of the hand (60%-70%), at
the wrist, and can also develop on the palmer surface. Most ganglion cyst causes some degree of pain however 35% are asymptomatic except for appearance.
Dupuyten’s contracture
-Thickening of the palmar and digital fascia
-Strong hereditary disposition; usually northern European young male
-Increased risk after the age of 40
-Men are more likely to develop this condition then women
-Maybe associated with epilepsy, alcoholic cirrhosis and diabetes
-Progressive permanent flexion sets in later with skin fold in the palm, due to the increased tension of the contractures (bowstring effect)
