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Hand and Wrist Examination: Difference between revisions
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==Sequence== | |||
===Inspection=== | |||
* Expose both limbs to the elbow | |||
** All aspects | |||
** Donโt forget forearm or ulna aspects | |||
* Seated, hands on pillow or desk | |||
** Posture/alignment | |||
** Tremor | |||
** Swelling | |||
** Colour | |||
** Wasting | |||
** Scars | |||
===Movement=== | |||
* Wrist | |||
** Observe supination/pronation rhythm as you inspect | |||
** Flexion/extension | |||
** Radial/ulnar deviation | |||
** Pronation/supination | |||
* Fingers | |||
** Flexion/Extension | |||
** MCPJs โ 0-90ยฐ | |||
** PIPJs โ 0-110ยฐ | |||
** DIPJs โ 0-90ยฐ | |||
** Abduction/Adduction | |||
* Thumb | |||
** Adduction, abduction, opposition, flexion, extension | |||
===Palpation=== | |||
'''Dorsal Wrist Pain''' | |||
[[File:dorsal-wrist-pain.jpg]] | [[File:dorsal-wrist-pain.jpg]] | ||
:A = Intersection syndrome | :A = Intersection syndrome | ||
Line 17: | Line 48: | ||
:L = ECU dislocation / tendonitis | :L = ECU dislocation / tendonitis | ||
'''Volar Wrist Pain''' | |||
ย | |||
[[File:volar-wrist.jpg]] | [[File:volar-wrist.jpg]] | ||
:A = FCU tendonitis | :A = FCU tendonitis | ||
Line 25: | Line 57: | ||
:E = Base of thumb arthritis | :E = Base of thumb arthritis | ||
===Special Tests=== | |||
Special Tests (depends on site of pain, ulnar, radial or mid) | |||
* Scapholunate instability - Watson test | |||
* DRUJ instability - Compression/ballotment test, Piano key, Drawer | |||
* Lunotriquetral instability โ lunotriquetral ballotment test | |||
* Finkelsteins | |||
* Radiocarpal and midcarpal drawer tests | |||
* Ulnocarpal stress test | |||
* ECU subluxation | |||
* 1st CMC OA โ CMC grind test, shuck test, see progressive adduction with hyperextension | |||
ย | |||
===Tendons=== | |||
ย | |||
===Neurological Exam=== | |||
[[Category:Examination]] | [[Category:Examination]] | ||
[[Category:Hand and Wrist]] | [[Category:Hand and Wrist]] |
Revision as of 19:38, 30 June 2021
This article is a stub.
Sequence
Inspection
- Expose both limbs to the elbow
- All aspects
- Donโt forget forearm or ulna aspects
- Seated, hands on pillow or desk
- Posture/alignment
- Tremor
- Swelling
- Colour
- Wasting
- Scars
Movement
- Wrist
- Observe supination/pronation rhythm as you inspect
- Flexion/extension
- Radial/ulnar deviation
- Pronation/supination
- Fingers
- Flexion/Extension
- MCPJs โ 0-90ยฐ
- PIPJs โ 0-110ยฐ
- DIPJs โ 0-90ยฐ
- Abduction/Adduction
- Thumb
- Adduction, abduction, opposition, flexion, extension
Palpation
Dorsal Wrist Pain
- A = Intersection syndrome
- B = De Quervainโs tenosynovitis
- C = Scaphoid fracture / Wartenbergs syndrome (nerve entrapment)
- D = Base of thumb arthritis
- E = Ulnar collateral ligament injury
- F = Carpal boss
- G = Scapholunate ligament tear
- H = Keinbockโs disease
- I = Lunotriquetral ligament tear
- J = DRUJ (distal radioulnar joint) arthritis / instability
- K = Ulnar impaction / TFCC tear
- L = ECU dislocation / tendonitis
Volar Wrist Pain
- A = FCU tendonitis
- B = Pisiotriquetral arthritis / Ulnar nerve entrapment / ulnar artery thrombosis
- C = Hook of hamate fracture
- D = Trigger finger
- E = Base of thumb arthritis
Special Tests
Special Tests (depends on site of pain, ulnar, radial or mid)
- Scapholunate instability - Watson test
- DRUJ instability - Compression/ballotment test, Piano key, Drawer
- Lunotriquetral instability โ lunotriquetral ballotment test
- Finkelsteins
- Radiocarpal and midcarpal drawer tests
- Ulnocarpal stress test
- ECU subluxation
- 1st CMC OA โ CMC grind test, shuck test, see progressive adduction with hyperextension