Hand & Wrist Deformities | Hand & Wrist Exam - MedSchool
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Hand & Wrist Exam
 
 
Hand & Wrist Exam
 
 
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There are several pathognomonic signs in the hand and wrist that are suggestive of rheumatoid arthritis or osteoarthritis. This page outlines these findings.
The Patient
Inspection
Palpation
Movement
Functional Tests
 

Hand & Wrist Deformities

 
 
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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.
Last updated on November 25th, 2019
 
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