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Wrist/hand Pathology

Orthopedic Pathologies of the wrist/hand

Differential DiagnosisSigns and Symptoms
Smith's Fracture Garden Spade fork deformity, Pain, Swelling, Pt tenderness, loss circulation
Carpal Tunnel Syndrome tingling/numbness hand, P! radiating from wrist, weakness in hands, loss sensation
Cyclist's Palsy sensory loss, weakness hand and thumb, numbness/tinling in hand, weak pinching
Bowler's Thumb numbness, P, tingling in thumb, decreased strength in thumb
Colle's Fracture P, swelling, loss ROM/function, snapping/crushing sound
Jersery Finger severe P, loss of function, palpable tendon on supinated hand, visible hematoma, unable flex DIP against resistance
Des Quervian's Disease increased P over tendons/radial styloid process, crepitus at thumb, Increased P w/ abd, gripping, flex of thumb (Finkelstein's)
Game Keeper Thumb P, swelling, bruising, increased P w/ ROM, jt laxity w/ abd/ext
Boutonniere Deformity P!/swelling over PIP jt, PIP flex DIP hyperext, unable to ext PIP
Phalanx Fracture P, pt tenderness, loss ROM, deformity, swelling, crepitus
Paronychia nail fold red/swollen, P w/ palpation, produce purulent matter
Scaphoid Fracture swelling, pt tenderness at snuff box, neuro deficits, loss grip strength, FOOSH, loss ROM, stiffness, P weight bearing (pushups)
Ulnar Neuropathy paresthesia ulnar nerve distribution, P small fingers, weak grip strength, P/pt tenderness ulnar of wrist, +tinnels, mm atrophy, unable to ext 5th
Radial Nerve Compression P/paresthesia over dorsal-radial wrist/hand, P ulnar deviation, abnormal sensations, difficulty ext elbow, mm weakness/atrophy, wrist/finger drop
Ganglion Cyst notable lump, tingling/loss ROM/burning if near nerve, dull P/ache, tenserness, swelling, weakness, loss ROM, growing/shrinking lump, movement painfull
Wrist Sprains swelling, P at time injury, P with wrist movement, bruising/discoloration, tenderness at injury site, popping/tearing at wrist, warm temp,
Lunate Dislocation/Subluxation localized tenderness, crepitus with movement, instability, decreased grip strength, median nerve symptoms, swelling, fingers in partial flex
Mallet Finger MOI:extreme/rapid flexion of finger, avulsion ext tendon, bone pull off w/ tendon, drooping finger tip, P, swelling, redness, unable ext DIP
Bennette’s Fracture thumb fracture, P at base thumb, rapid swelling, decrease ROM, complications maybe tramatic arthritis, visible deformity, may have circulation problems (coldness/numbness in thumb)
IP Dislocations stiffness, P, loss ROM, edema, deformity, numbness involved digit, instability jt, increased P w/ valgus/varus/distraction
Subungal Hematoma increased P w/ pressure, black/bruised nail, blood underneath nail, nail may fall off, possible broken toe/finger
Hamate Fracture decreased grip strength, P over hamate/with grip/flex 4th and 5th/with dorsi-ulnar deviation, nerve problems if impingment, tendonitis of flex tendons, wrist weakness
Boxer’s Fracture fracture 5th, swelling, tenderness, deformity, heard crack/pop, P, bruising, weak/numb hand, abnormal bone movement, possible cut due to punching a wall
Created by: ATskg