Hand Examination

[ Home ] [ Up ]

Pages Below:

Hand Examination

Observation

General
- cachexia
- psoriatic skin rash
Face
- Cushingoid→ Rheumatoid arthritis, Systemic Lupus Erythematosus,
- Exophthalmos → Thyroid acropachy
- Acromegaly → Carpal Tunnel Syndrome, Diabetic Neuropathy, Thickened nerves
- Heilotrope → Dermatomyositis

Hands

Inspect

(rest on pillow in front of patient)

Dorsal surface
Palmar surface
Side
Knuckles
Praying

Nails
- Clubbing
- Splinter Haemorrhages → Infective Endocarditis
- Leuconychia → low protein
- Nail bed infarct → Rheumatoid arthritis, Systemic sclerosis
- Pitting, ridging → psoriasis
Skin
- tight → Scleroderma / CREST
- Steroidal
- Raynaud's Phenomenon
- Spider Naevi
- Gouty tophi
- Rash of Dermatomyositis
- Palmar pigmentation
- Tendon xanthomata
Joints
- observe
  - swelling
  - deformity
  - inflammation
Muscles
- wasting
  - interossei
  - thenar eminence
  - hypothenar eminence

Palpate

temperature
Joints
- squeeze MCP, IP
- over thumb joints
- rdiocarpal joints
- inferior radioulnar
- for
  - tenderness
  - synovial thickening
  - Heberdens Nodes
  - Osler's Nodes
Palms
- rheumatoid nodules
- Dupuytren's contracture
- Erythema
Wrists
- peripheral pulses
Elbows
- Gouty tophi
- Rheumatoid nodules
- Psoriatic plaques
- Tendon xanthomata

Move

joints
- each in turn

Power

weakness
- 1st dorsal interosseous → Ulnar Nerve Lesion
- abductor pollicis brevis → Median Nerve Lesion

sensation

pin prick
joint position sense
vibration

Function

Others

[ Home ] [ Up ]