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.
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