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Hand & Wrist Exam
 
Hand & Wrist Exam

 

 

 

 

Hand & Wrist Deformities

 
 
 
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On this page:Ulnar DeviationBoutonniere DeformitySwan Neck DeformityZ-Thumb DeformityHeberden’s NodesBouchard’s Nodes
 View Topic Outline

Overview

  • There are several pathognomonic signs in the hand and wrist that are suggestive of rheumatoid arthritis or osteoarthritis. This page outlines these findings.

Ulnar Deviation

    • Look For

    • Ulnar (medial) deviation of the metacarpophalangeal joints.

    • Significance

    • A sign of rheumatoid arthritis.

Boutonniere Deformity

    • Look For

    • Flexion at the proximal interphalangeal joint with hyperextension at the metacarpophalangeal and distal interphalangeal joint

    • Significance

    • A sign of rheumatoid arthritis.

Swan Neck Deformity

    • Look For

    • Hyperextension at the proximal interphalangeal joint joint with flexion at the metacarpophalangeal and distal interphalangeal joint

    • Significance

    • A sign of rheumatoid arthritis.

Z-Thumb Deformity

    • Look For

    • Flexion at the interphalangeal joint at the thumb with hyperextension at the metacarpophalangeal joint

    • Significance

    • A sign of rheumatoid arthritis.

Heberden’s Nodes

    • Look For

    • Firm swellings over the distal interphalangeal joints.

    • Significance

    • A sign of osteoarthritis.

Bouchard’s Nodes

    • Look For

    • Firm swellings over the proximal interphalangeal joints.

    • Significance

    • A sign of osteoarthritis.
 
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