Hand and Wrist Osteoarthritis Quiz

A positive Froment's sign is seen when the thumb tip cannot fully extend and instead bends inwards, indicating weakness in the adductor pollicis muscle.

Purpose: To assess the distal median nerve.Technique: The therapist passively presses the dorsal sides of the patient's hands against each other at about chest height for 15 to 60 seconds. A positive test is the production of numbness and tingling in the distribution of the median nerve.

Purpose: Tests for median nerve compression by the pronator teres.Technique: The therapist stabilizes the patient's elbow and grasps their hand in a handshake position, then resists supination while extending the elbow. A positive test is numbness, tingling, or pain along the median nerve distribution.

Purpose: To assess for De Quervain's tenosynovitis.Technique: The patient makes a fist with their thumb tucked inside, then ulnarly deviates their wrist. A positive test is pain over the anatomical snuffbox.

Purpose: To assess scapholunate ligament instability. Technique: The therapist places their thumb over the patient's scaphoid and moves the wrist radially while flexing, applying pressure to the scaphoid. With ligament laxity, the scaphoid will shift dorsally and return with a clunk when pressure is released.

A positive Phalen's test is characterized by numbness and tingling in the median nerve distribution, suggesting potential compression of the nerve.

The therapist's thumb opposes the normal palmar movement of the scaphoid, inducing subluxation stress.

In a normal wrist, the scaphoid moves palmarly as the wrist radially deviates and flexes.

Osteoarthritis affecting the wrist joint, often caused by a fall onto the outstretched thumb.

A type of treatment that focuses on non-surgical methods to manage osteoarthritis symptoms.

Injections directly into the joint, often using corticosteroids to reduce inflammation and pain.

A surgical procedure that aims to fuse the bones of a joint together, reducing mobility but often decreasing pain.

A surgical procedure that replaces damaged joint surfaces with artificial components, aiming to maintain function.

A test that involves ulnarly deviating and axially loading the patient's wrist, then moving it volarly and dorsally, looking for crepitus and reproduction of symptoms. This test may indicate a tear of the triangular fibrocartilage complex (TFCC) or ulnocarpal abutment.

A test that involves tapping on a nerve four to six times and checking for symptoms related to nerve impairment. This test is used to assess for nerve compression or irritation.

A test that involves stabilizing the distal radius and attempting to passively translocate the patient's ulna volarly and dorsally in various degrees of pronation and supination. Pain, tenderness, and increased mobility suggest involvement of the distal radioulnar joint (DRUJ).

A test that involves tapping directly on a bone or using a tuning fork to check for pain or a fracture. This test is used to assess for bone tenderness or fractures.

The most common tendinopathy of the wrist in athletes, characterized by inflammation of the tenosynovium of the first dorsal compartment tendons, the abductor pollicis longus (APL) and extensor pollicis brevis (EPB).

A tear of the extensor pollicis longus (EPL) tendon at Lister's tubercle, often occurring as a delayed complication of a non-displaced distal radial fracture.

Intersection Syndrome involves inflammation at the intersection of the abductor pollicis longus/extensor pollicis brevis (APL/EPB) and extensor carpi radialis longus/extensor carpi radialis brevis (ECRL/ECRB) tendons.

Inflammation of the tendons responsible for the extension of the fingers at the metacarpophalangeal joint (MCP), known as the extensor digitorum (ED) and extensor indicis (EI) tendons.

The cubital tunnel is a narrow space located at the posterior-medial elbow, formed by the fascia of the Flexor Carpi Ulnaris (FCU) and the cubital tunnel retinaculum (CTR).

The cubital tunnel retinaculum (CTR) is a fibrous band that extends from the medial epicondyle to the tip of the olecranon. It acts as the roof of the cubital tunnel.

The ulnar nerve, originating from the medial cord of the brachial plexus, passes through the cubital tunnel. This nerve is responsible for innervating the FCU, FDP for digits 4 and 5, and other muscles of the hand.

Positive Tinel's sign at the elbow can indicate ulnar nerve entrapment, causing symptoms like tingling, numbness, and weakness in the little and ring finger. Tapping over the cubital tunnel may reproduce these symptoms.

Ulnar nerve entrapment can manifest as weakness and atrophy of the hand muscles, particularly in the web space between the thumb and index finger. This happens due to disruption of the adductor muscle innervation by the ulnar nerve.

A fracture at the bottom of the thumb bone, usually caused by direct force to the thumb. It often involves a dislocation and can be painful and difficult to heal.

A fracture of the wrist bone (radius) where the bone is displaced towards the back of the hand. It is the most common type of wrist fracture caused by a fall.

A fracture of the small bone in the wrist (scaphoid) often caused by a fall on an outstretched hand. It can be tricky to diagnose and is prone to complications if not treated properly.

A fracture of the fifth metacarpal bone in the hand caused by punching an object, often resulting in a 'deformed' pinky finger.

A fracture of the bone in the little finger (distal phalanx) typically caused by forcing the finger into a bent position.

A fracture of the bone in the palm (metacarpal) involving the joint at the base of the finger. It's often associated with forceful twisting injuries.

A fracture of the long bone in the upper arm (humerus), often caused by direct impact or a fall.

A fracture of the small bone in the wrist (hamate) typically caused by repetitive forceful movements of the hand, often seen in athletes.

A fracture of the radial styloid process, often caused by a fall onto an outstretched hand.

A fracture of the distal ulnar styloid process. As long as the distal radioulnar joint (DRUJ) is not affected, it usually doesn't lead to long-term problems.

A fracture of the middle or distal third of the radius combined with a dislocation or subluxation of the DRUJ. This injury requires surgical treatment.

A fracture at the end of the radius that occurs often due to a fall on a flexed wrist, possibly resulting in instability within the DRUJ, shortening of the radius, and carpal tunnel syndrome as a long-term complication.

The scaphoid bone is the most common carpal bone to fracture, often treated with a thumb spica splint. The other bones (triquetrum and lunate) are less common.

These fractures require immobilization for varying periods. Non-displaced fractures are treated with a cast, while displaced fractures might need closed reduction or surgery. Physical therapy aims to restore range of motion and strength.

Flexor digitorum superficialis, flexor digitorum profundus, flexor pollicis longus.

Injury to the lateral bands, which are located within the extensor expansion of the hand, results in two common deformities: Boutonniere deformity and swan neck deformity.