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