Common Hand Conditions Flashcards
What is a mucous cyst?
An outpouching of synovial fluid from the DIPJ in OA
May deform nail or cause a ridge
What is a ganglion?
An outpouching of the synovial cavity, filled with synovial fluid
Usually painless
How is a ganglion managed?
Benign neglect
Aspiration
Excsion (never do this really)
What is trigger finger?
Pain when the tendon runs over the A1 pulley due to a little nodule on the irritaed tendon
Stenosing tenosynovitis that via fibrocatilaginous metaplasia forms a nodule on the FDS tendon
How will trigger finger look on examination?
Demonstrate triggering
Tendon over A1 pulley
Feel nodule passing beneath pulley
How can trigger finger be distinguished from duputryens?
Duptruyens will never open
How is trigger finger managed?
Conservative - resolves spontaneously
Tendon sheath injection - steroid and LA
Surgery - under GA or LA to divide L1 pulley
What is paronychia?
An infection within the nail fold that often occurs in children
How is paronychia managed?
Elevate
Antibiotics
Incise and drain collection
What is a tendon sheath infection?
Infection within the tendon sheath that tracks up the palm and arm
V painful
Limited extension (including passive) due to pain
May have tracking lymphangitis
How are tendon sheath infections managed?
Wash out tendon sheath
Antibiotics
What is de Quervains tenosynovitis?
Tendon sheath pathology that affects the first extensor compartment (APL and EBP) causing pain whilst using thumb and tenderness over the compartment
What clinical test is doen in de Quervains tenosynovitis?
Finklesteins test
How is De Quervains tenosynovitis treated?
Splint Rest PT Analgesics Inject Try to avoid surgical decompression
What can cause an EPL rupture?
Few weeks after an undisplaced distal radial fracture
