Hand Examination

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General inspection :

Nails

  • Onycholitis                {separation nail}
  • Clubbing
  • Pitting
  • Koilonychia               {Spoon nails – iron defn anaemia}
  • Leukonychia                         {white lines }
  • Beau’s lines              {transverse linear depressions – illness, trauma, malnutrition}
  • Brown Lines                          {Renal – build up waste}
  • Telangiectasia                      { Dermatomyositis}

 

Shape Hands

  • Arachnodactyly                     {Marfans, Homocystinuria, MEN 2B}
  • Short 4th/5th metacarpal     {PseudohypoPTH, Turners}
  • Trident

 

Posture Hand

  • Claw { Ulna N}                      Hyperextension MCP – weakness interossei M
  • Wrist drop                              Radial N palsy
  • Ulnar deviation                     {RH arthritis}

 

Colour, Temp, Sweating

 

Joints, tendon sheaths              { DIP, PIP, MCP}

 

  1. Feel
  2. Move
  3. Function                                 { Buttons, writing, grip}
  4. Wrists
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