Hand & Wrist Deformities
On this page:Ulnar DeviationBoutonniere DeformitySwan Neck DeformityZ-Thumb DeformityHeberden’s NodesBouchard’s Nodes
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.
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------