Complex Regional Pain Syndrome Review
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Questions and Answers

What is the primary wrist stability provided by?

ligaments

What deformity is characterized by a radius fracture within 2.5 cm of the wrist with the distal radius displaced in a dorsal direction?

dinner fork deformity

What wrist injury often results from a fall with the wrist hyperextended?

wrist sprains

What is the therapy goal in managing Complex Regional Pain Syndrome (CRPS)?

<p>Reduce swelling</p> Signup and view all the answers

What is the common pathophysiology of a scaphoid fracture?

<p>Fractures in the proximal pole (proximal 1/3 of scaphoid) are more likely to result in non-union and avascular necrosis due to poor blood supply.</p> Signup and view all the answers

What is the characteristic mechanism of injury associated with a scaphoid fracture?

<p>Wrist hyperextension with radial deviation.</p> Signup and view all the answers

What is the common name for Dupuytren’s contracture and what age group is it most prevalent in?

<p>Also known as 'The Pope Sign', Dupuytren’s contracture primarily affects individuals aged 40 and older.</p> Signup and view all the answers

How is Dupuytren’s contracture typically treated?

<p>Surgical intervention to excise the palmar fascia or perform a fasciectomy.</p> Signup and view all the answers

What is the characteristic feature of boutonniere deformity?

<p>Flexion at the PIP joint and hyperextension at the DIP joint.</p> Signup and view all the answers

What treatment is recommended for DeQuervain's Tenosynovitis?

<p>Wrist and thumb immobilization, modalities to decrease swelling and pain</p> Signup and view all the answers

What is a common symptom of DeQuervain's Tenosynovitis?

<p>Pain and swelling at the radial styloid</p> Signup and view all the answers

What is the purpose of Finklestein's Test?

<p>To diagnose DeQuervain's Tenosynovitis</p> Signup and view all the answers

How should resistance exercise be focused for DeQuervain's Tenosynovitis?

<p>On contractions that do not produce symptoms</p> Signup and view all the answers

What is the recommended action if pain and swelling are reduced in DeQuervain's Tenosynovitis?

<p>Begin active motion of wrist and thumb</p> Signup and view all the answers

What is the typical treatment for Mallet finger?

<p>Splinting the DIP joint for 6 to 10 weeks in zero degrees extension</p> Signup and view all the answers

Describe the deformity that results in the Boutonniere deformity.

<p>A rupture or stretch to the extensor tendon at the PIP joint, causing PIP flexion and DIP hyperextension.</p> Signup and view all the answers

What area of the hand is known as 'no man’s land' when it comes to tendon lacerations?

<p>The area of palm from the distal palmar crease to the middle phalanx.</p> Signup and view all the answers

What is the characteristic presentation of Swan neck deformity?

<p>PIP hyperextension and DIP flexion.</p> Signup and view all the answers

What is the progression from static splinting for tendon lacerations?

<p>Dynamic splinting, allowing partial active extension and passive flexion.</p> Signup and view all the answers

What are the two joints that make up the wrist joint?

<p>Radiocarpal and midcarpal joints</p> Signup and view all the answers

What carpal bones make up the distal part of the radiocarpal joint?

<p>Scaphoid, lunate, and triquetrum</p> Signup and view all the answers

What type of joint is the radiocarpal joint?

<p>Condyloid joint</p> Signup and view all the answers

Which ligament attaches to the radial styloid and trapezium and scaphoid, providing lateral support?

<p>Radial collateral ligament</p> Signup and view all the answers

What is the common pathologies of the wrist that involves the entrapment of the median nerve?

<p>Carpal Tunnel Syndrome (CTS)</p> Signup and view all the answers

What is the purpose of placing a distal cast proximal to the distal palmar crease?

<p>Facilitate exercises</p> Signup and view all the answers

What is Complex Regional Pain Syndrome (CRPS) also known as?

<p>RSD (reflex sympathetic dystrophy)</p> Signup and view all the answers

List three characteristics of Complex Regional Pain Syndrome (CRPS)

<p>Pain, Hyperesthesia, Edema</p> Signup and view all the answers

Does the severity of the injury directly correlate with the severity of pain experienced in CRPS?

<p>No</p> Signup and view all the answers

What is Smith’s fracture and how does it differ from a Colles Fracture?

<p>A reverse Colles Fracture - the rigid fragment displaced in palmar direction instead of dorsal</p> Signup and view all the answers

Describe the common clinical symptoms associated with median nerve compression.

<p>Numbness, tingling, pain in wrist, clumsiness in hand activities, weak grip, swelling, atrophy in thenar muscles</p> Signup and view all the answers

What special test involves pressing the backs of hands together to elicit a tingling response in median nerve compression?

<p>Phalen’s test</p> Signup and view all the answers

Which test involves tapping the ventral wrist to stimulate a tingling response in the median nerve?

<p>Tinel’s test</p> Signup and view all the answers

What is the treatment approach for managing median nerve compression?

<p>Eliminate motions causing symptoms, splinting, corticosteroid injections, elbow and shoulder exercise, decompression surgery if necessary</p> Signup and view all the answers

What deformity is characterized by a radius fracture within 2.5 cm of the wrist with the distal radius displaced dorsally?

<p>Boutonniere deformity</p> Signup and view all the answers

What is tested by the Digital Allen Test?

<p>Radial and digital artery circulation recovery</p> Signup and view all the answers

What is the primary focus of exercise for a patient with median nerve compression?

<p>Elbow and shoulder range of motion and strengthening</p> Signup and view all the answers

What surgical procedure involves cutting the transverse ligament to release pressure on the median nerve?

<p>Decompression surgery</p> Signup and view all the answers

What is the common outcome of decompression surgery for median nerve compression?

<p>Scarring</p> Signup and view all the answers

What is the major cause of median nerve compression?

<p>Repetitive motion of the wrist</p> Signup and view all the answers

Match the following ligaments with their attachment sites:

<p>Radial collateral ligament = Attaches to radial styloid and trapezium and scaphoid Ulnar collateral ligament = Attaches to ulnar styloid and pisiform and triquetrum Palmar radiocarpal ligament = Attaches to anterior ulna and radius and to the anterior surface of the proximal carpals Dorsal radiocarpal ligament = From posterior surface of the distal radius to posterior scaphoid, lunate, and triquetrum</p> Signup and view all the answers

Match the following wrist joint characteristics with their descriptions:

<p>Radiocarpal joint = Made of distal radius and radioulnar disk proximally, and scaphoid, lunate, and triquetrum distally Midcarpal joint = Between the two rows of carpal bones, contributing to wrist motion Synovial joint = Condyloid type allowing biaxial movement Plane joint = Non-axial joint allowing plane motion</p> Signup and view all the answers

Match the following common wrist pathologies with their characteristics:

<p>Carpal Tunnel Syndrome = Affects 4% of the entire US workforce due to entrapment of the median nerve within the carpal tunnel DeQuervain's Tenosynovitis = Characterized by pain and swelling at the base of the thumb Scaphoid Fracture = Associated with a characteristic mechanism of injury Dupuytren's Contracture = Commonly known as 'Viking disease'</p> Signup and view all the answers

Match the following deformities with their descriptions:

<p>Boutonniere Deformity = Results from a rupture of the central slip of the extensor mechanism at the PIP joint with flexion at PIP and hyperextension at DIP Swan Neck Deformity = Characterized by hyperextension at PIP and flexion at DIP due to imbalance in intrinsic muscles Smith's Fracture Deformity = Distal radius displaced in a volar direction Colles Fracture Deformity = Distal radius displaced dorsally</p> Signup and view all the answers

Match the following terms with their explanations:

<p>CRPS (Complex Regional Pain Syndrome) = Also known as reflex sympathetic dystrophy (RSD) or causalgia Smith's Fracture = Fracture within 2.5 cm of the wrist with distal radius displaced in a volar direction Scaphoid Fracture Pathophysiology = Associated with poor vascularity leading to high risk of non-union Dupuytren's Contracture Treatment = Surgical procedure involving fasciectomy or collagenase injection</p> Signup and view all the answers

Match the following descriptions with the correct condition: 1) Distal and midportion of the scaphoid have good blood supply, proximal pole has poor blood supply; 2) Most common carpal bone fracture due to wrist hyperextension with radial deviation

<p>Scaphoid fracture = Scaphoid fracture Dupuytren's contracture = Dupuytren's contracture CRPS = Complex Regional Pain Syndrome Smith's fracture = Smith's fracture</p> Signup and view all the answers

Match the following clinical features with the correct condition: 1) Contracture of longitudinal bands of palmar aponeurosis; 2) Contracture primarily seen in 4th and 5th digits

<p>Scaphoid fracture = Scaphoid fracture Dupuytren's contracture = Dupuytren's contracture CRPS = Complex Regional Pain Syndrome Smith's fracture = Smith's fracture</p> Signup and view all the answers

Match the following treatments with the correct condition: 1) Surgical intervention to excise palmar fascia or perform a fasciectomy; 2) Extended healing time up to 24 weeks

<p>Scaphoid fracture = Scaphoid fracture Dupuytren's contracture = Dupuytren's contracture CRPS = Complex Regional Pain Syndrome Smith's fracture = Smith's fracture</p> Signup and view all the answers

Match the following mechanisms of injury with the correct condition: 1) Wrist hyperextension with radial deviation; 2) Fall resulting in wrist being hyperextended

<p>Scaphoid fracture = Scaphoid fracture Dupuytren's contracture = Dupuytren's contracture CRPS = Complex Regional Pain Syndrome Smith's fracture = Smith's fracture</p> Signup and view all the answers

Match the following pathologies with the correct condition: 1) Involves entrapment of median nerve; 2) Commonly known as 'The Pope Sign'

<p>Scaphoid fracture = Scaphoid fracture Dupuytren's contracture = Dupuytren's contracture CRPS = Complex Regional Pain Syndrome Smith's fracture = Smith's fracture</p> Signup and view all the answers

Match the following complications with the corresponding wrist pathology:

<p>Non-union = Scaphoid fracture Tendon adhesions = Colles fracture Instability = Dupuytren's contracture Volkmann’s ischemic contracture = Complex Regional Pain Syndrome (CRPS)</p> Signup and view all the answers

Match the following deformities with the corresponding wrist injury:

<p>Boutonniere deformity = Colles fracture Swan neck deformity = Scaphoid fracture Dinner Fork Deformity = Smith's fracture Dupuytren's contracture = Complex Regional Pain Syndrome (CRPS)</p> Signup and view all the answers

Match the following common outcomes with the corresponding wrist pathology:

<p>Mal-union = Dupuytren's contracture Median nerve compression = Scaphoid fracture CRPS = Complex Regional Pain Syndrome (CRPS) Flexor tendons affected = Smith's fracture</p> Signup and view all the answers

Match the following therapy goals with the corresponding wrist condition:

<p>Reduce swelling, maintain motion = Scaphoid fracture Non-painful exercises to maintain motion = Complex Regional Pain Syndrome (CRPS) Rigid cast and reduction if needed = Colles fracture Tape reinforcement for weak ligaments = Dupuytren's contracture</p> Signup and view all the answers

Match the following characteristics with the corresponding wrist pathology:

<p>Most common wrist fracture = Colles fracture Known as 'no man’s land' in tendon lacerations = Scaphoid fracture Entails cutting transverse ligament for release of median nerve pressure = Dupuytren's contracture Requires gentle active ROM exercises post-removal of splint = Complex Regional Pain Syndrome (CRPS)</p> Signup and view all the answers

Match the special test with the wrist pathology it is associated with:

<p>Phalen's Test = Carpal tunnel syndrome (CTS) Tinel's Test = Carpal tunnel syndrome (CTS) Digital Allen Test = Scaphoid fracture Finklestein's Test = DeQuervain's Tenosynovitis</p> Signup and view all the answers

Match the treatment approach with the wrist pathology it is primarily used for:

<p>Eliminate motions that create symptoms, splinting, corticosteroid injection, exercise = Complex Regional Pain Syndrome (CRPS) Transverse ligament release surgery = Carpal tunnel syndrome (CTS) Exercise of affected limb, elbow and shoulder ROM, strengthening, splinting = Dupuytren's contracture Distal cast proximal to distal palmar crease, pain management = Scaphoid fracture</p> Signup and view all the answers

Match the deformity with the wrist pathology it is associated with:

<p>Swan neck deformity = Dupuytren's contracture Boutonniere deformity = Complex Regional Pain Syndrome (CRPS) Dinner Fork Deformity = Scaphoid fracture Smith's fracture deformity = Smith's fracture</p> Signup and view all the answers

Match the common clinical symptoms with the wrist pathology they are associated with:

<p>Numbness, tingling, pain in wrist, weak grip = Complex Regional Pain Syndrome (CRPS) Weak grip, swelling in hand and forearm, atrophy in thenar muscles = Dupuytren's contracture Clumsiness in hand activities, weak grip in pinch and thumb action = Scaphoid fracture Pain in wrist but can be muscular, symptoms worse at night = Carpal tunnel syndrome (CTS)</p> Signup and view all the answers

Match the ligament or joint stability with the wrist pathology it is related to:

<p>Transverse ligament release surgery effect on stability = Carpal tunnel syndrome (CTS) Radial styloid and trapezium/scaphoid ligament attachment = Complex Regional Pain Syndrome (CRPS) Primary wrist stability provider = Scaphoid fracture Distal part of radiocarpal joint carpal bones = Dupuytren's contracture</p> Signup and view all the answers

Match the following wrist pathologies with their characteristics:

<p>Scaphoid fracture = Pain in anatomical snuffbox, high risk of avascular necrosis Complex Regional Pain Syndrome (CRPS) = Pain, hyperesthesia, edema, discoloration, loss of motion and function Smith's fracture = Reverse Colles fracture, rigid fragment displaced palmarly Dupuytren's contracture = Progressive fibrosis of palmar fascia, finger contractures</p> Signup and view all the answers

Match the following descriptions with the appropriate wrist pathology:

<p>Presents with pain in anatomical snuffbox and high risk of avascular necrosis = Scaphoid fracture Characterized by progressive fibrosis of palmar fascia leading to finger contractures = Dupuytren's contracture Involves pain, hyperesthesia, edema, discoloration, and loss of motion and function = Complex Regional Pain Syndrome (CRPS) A reverse Colles fracture where the rigid fragment displaces palmarly = Smith's fracture</p> Signup and view all the answers

Match the following wrist pathologies with their associated complications:

<p>Scaphoid fracture = High risk of avascular necrosis if not treated promptly Complex Regional Pain Syndrome (CRPS) = Vasomotor response to chronic stimulus, can follow various injuries Smith's fracture = Displacement of rigid fragment in palmar direction instead of dorsal Dupuytren's contracture = Progressive fibrosis leading to finger contractures</p> Signup and view all the answers

Match the following wrist pathologies with their common clinical symptoms:

<p>Scaphoid fracture = Pain in anatomical snuffbox region Complex Regional Pain Syndrome (CRPS) = Pain, hyperesthesia, edema, discoloration Smith's fracture = Displacement of fragment palmarly instead of dorsally Dupuytren's contracture = Palmar fascial fibrosis leading to finger contractures</p> Signup and view all the answers

Match the descriptions with the correct wrist pathology:

<p>Involves high risk of avascular necrosis if not promptly treated = Scaphoid fracture Characterized by pain, hyperesthesia, edema, and discoloration = Complex Regional Pain Syndrome (CRPS) Shows displacement of rigid fragment in palmar direction instead of dorsal = Smith's fracture Leads to progressive fibrosis of palmar fascia and finger contractures = Dupuytren's contracture</p> Signup and view all the answers

Match the following common wrist pathologies with their characteristics:

<p>DeQuervain's Tenosynovitis = Affects tendons of abductor pollicis longus and extensor pollicis brevis Scaphoid Fracture = Commonly results from a fall with wrist hyperextension Dupuytren's Contracture = Common outcome of decompression surgery is a limited range of motion CRPS (Complex Regional Pain Syndrome) = Managed with the therapy goal of reducing pain and improving function</p> Signup and view all the answers

Match the following deformities with their descriptions:

<p>Boutonniere Deformity = Characterized by PIP joint flexion and DIP joint hyperextension Swan Neck Deformity = Characterized by PIP joint hyperextension and DIP joint flexion Dinner Fork Deformity = Common wrist fracture known as Colles fracture No Man's Land = Area of hand vulnerable to tendon lacerations due to poor blood supply</p> Signup and view all the answers

Match the following special tests with their purposes:

<p>Finklestein's Test = Used to diagnose DeQuervain's Tenosynovitis Digital Allen Test = Tests for collateral circulation in the hand Tap Test = Involves tapping the ventral wrist to detect median nerve compression Distal Palmar Crease Test = Assesses tendon function post-splinting for lacerations</p> Signup and view all the answers

Match the following treatments with their corresponding pathologies:

<p>Wrist and Thumb Immobilization = Recommended for DeQuervain's Tenosynovitis Transverse Ligament Release Surgery = Treatment for median nerve compression Modalities to Decrease Swelling and Pain = Beneficial for scaphoid fractures Therapeutic Massage to Reduce Scarring = Useful for Dupuytren's contracture</p> Signup and view all the answers

Match the following ligaments with their attachment sites:

<p>Radioscaphocapitate Ligament = Attaches to radial styloid and scaphoid, providing lateral support Transverse Carpal Ligament = Attaches to trapezium and scaphoid, providing carpal tunnel support Dorsal Radiocarpal Ligament = Attaches to dorsal wrist, providing stability during wrist extension Palmar Ulnocarpal Ligament = Attaches to ulnar side, supporting wrist flexion</p> Signup and view all the answers

Match the following wrist pathologies with their characteristic features:

<p>Scaphoid fracture = Commonly associated with a fall on an outstretched hand Complex Regional Pain Syndrome (CRPS) = Characterized by severe pain, swelling, and changes in skin color and temperature Smith's fracture = Distinct from Colles' fracture by the direction of distal radius displacement Dupuytren's contracture = Commonly known as 'Viking disease' and prevalent in older age groups</p> Signup and view all the answers

Match the following wrist pathologies with their typical treatment approach:

<p>Scaphoid fracture = Often requires immobilization in a cast or surgery with internal fixation Complex Regional Pain Syndrome (CRPS) = Management involves a multidisciplinary approach including physical therapy, medications, and nerve blocks Smith's fracture = May require closed reduction and casting followed by physical therapy Dupuytren's contracture = Treatment options include needle aponeurotomy, collagenase injections, or surgical fasciectomy</p> Signup and view all the answers

Match the following wrist pathologies with their common clinical symptoms:

<p>Scaphoid fracture = Tenderness in the anatomical snuffbox area with pain on axial loading of the thumb Complex Regional Pain Syndrome (CRPS) = Excessive pain, edema, changes in skin temperature, and abnormal hair/nail growth Smith's fracture = Pain, swelling, and limited range of motion at the wrist Dupuytren's contracture = Formation of nodules and thick cords in the palm leading to finger contractures</p> Signup and view all the answers

Match the following wrist pathologies with their recommended actions:

<p>Scaphoid fracture = Prompt immobilization to prevent nonunion and avascular necrosis Complex Regional Pain Syndrome (CRPS) = Early diagnosis and aggressive treatment to prevent progression to irreversible changes Smith's fracture = Evaluation for associated injuries and monitoring for signs of compartment syndrome Dupuytren's contracture = Regular monitoring for disease progression and consideration of intervention based on severity</p> Signup and view all the answers

Match the following wrist pathologies with their characteristic presentations:

<p>Scaphoid fracture = Painful snuffbox tenderness with decreased range of motion at the wrist Complex Regional Pain Syndrome (CRPS) = Severe pain disproportionate to the inciting event along with autonomic dysfunction Smith's fracture = Sudden onset of wrist pain and visible deformity on physical examination Dupuytren's contracture = 'Pitting' or 'dents' on the skin surface along with flexion contractures of fingers</p> Signup and view all the answers

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