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Hand & Wrist Exam

Hand & Wrist Swelling

October 12th, 2020

Joint Swelling

  • Look For

  • Generalised swelling over one or both wrists. May be associated with redness, tenderness or warmth.
  • Causes of Joint Swelling

  • Trauma - fracture, muscle sprain or rupture, compartment syndrome
  • Musculoskeletal - osteoarthritis, rheumatoid arthritis, septic arthritis, gout, pseudogout, reactive arthritis, psoriatic arthritis, tenosynovitis
  • Skin / soft tissue infection - cellulitis, abscess, necrotizing fasciitis, gas gangrene
  • Vascular - acute ischaemia, DVT, superficial thrombophlebitis, venous insufficiency, lymphoedema
  • Systemic - heart failure, cirrhosis, nephrotic syndrome, malnutrition


  • Look For

  • Inflammation of an entire digit due to synovitis of each joint, resulting in a 'sausage-like' digit.
  • Significance

  • Dactylitis is classically pathognomonic of psoriatic arthritis.
  • Causes of Dactylitis

  • Psoriatic arthritis
  • Reactive arthritis
  • Sarcoidosis
  • Gout
  • Tuberculosis
  • Flexor tendon sheath infection
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