Orthopedics Book

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Rheumatologic Conditions affecting the Hand

Aka: Rheumatologic Conditions affecting the Hand, Rheumatologic Conditions affecting the Wrist, Hand associated Rheumatologic Conditions, Wrist associated Rheumatologic Conditions
  1. See also
    1. Overuse Syndromes of the Hand and Wrist
    2. Fall on Outstretched Hand
    3. Hand Anatomy
    4. Hand Dermatitis
    5. Hand Osteoarthritis
  2. Findings: Degenerative Arthritis (Osteoarthritis)
    1. Heberden's Nodes involve DIP Joints
    2. Bouchard's Nodes involve PIP Joints
    3. First carpal-Metacarpal joint involvement (thumb)
    4. Secondary degenerative Arthritis
      1. Hemochromatosis: involves second and third MCP joints
      2. Superimposed Gouty Arthritis of PIP and DIP joints
  3. Findings: Rheumatoid Arthritis
    1. Symmetrical swelling PIP, MCP and wrist
    2. DIP joint involvement is rare in Rheumatoid Arthritis
    3. Extensor Tenosynovitis or rupture may occur
  4. Findings: Psoriasis
    1. Involves any hand joint (especially DIP joints)
    2. Sausage-like swelling of digits
    3. Classic psoriatic Plaque and Nail Pitting (60-80%)
  5. Findings: Gout
    1. Tophi may be present
    2. Monoarticular Arthritis most common
  6. Findings: Pseudogout
    1. Wrists characteristically involved
    2. Older patients with acute Wrist Pain and swelling
    3. Other hand joints rarely involved
  7. Findings: Gonococcal Arthritis
    1. Common onset in young women at start of Menses
    2. Wrist Tenosynovitis may occur
    3. Classic vesicular rash seen in Gonorrhea
  8. Findings: Systemic Sclerosis and Scleroderma
    1. Fingertip atrophy
    2. Calcific Nodules
    3. Digital Cyanosis
    4. Sclerodactyly: tightening of skin around digits

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