Orthopedics Quiz: Hand and Wrist Conditions

A test for De Quervain's tenosynovitis; flexing the thumb into the palm and ulnarly deviating the wrist. Pain in the 1st dorsal compartment suggests a positive result.

A test for scaphoid instability; pushing on the distal scaphoid while moving the wrist. A clunk or click suggests instability.

Pain in the anatomic snuffbox. This area over the scaphoid bone may indicate a scaphoid fracture.

Injury to the ulnar collateral ligament of the thumb, caused by a forceful radial deviation. Marked radial instability is the physical finding.

Tapping the volar wrist to assess median nerve compression. Tingling, reproduced symptoms suggest a positive result (carpal tunnel syndrome).

Holding both wrists in flexion for one minute. Pain or numbness indicates compression, suggestive of carpal tunnel syndrome.

Inflammation of the tendons on the side of the wrist that control thumb movement.

A condition caused by compression of the median nerve in the wrist.

A peripheral neuropathy caused by median nerve compression by the transverse carpal ligament.

A fibroproliferative disorder of the palmar fascia, most common in the 4th & 5th fingers.

Most common carpal bone fracture, often from falling onto an outstretched hand (FOOSH).

Repetitive thumb abduction and extension cause inflammation in the wrist extensor tendons.

Ulnar nerve compression in the wrist, causing hypothenar muscle atrophy and numbness.

Also known as "Golfer's Elbow", it's an inflammation of the tendons that attach to the inner bony bump (medial epicondyle) of the elbow. This happens due to overuse or repetitive strain.

Have the patient supinate their arm (palm up), extend their wrist and elbow, then apply pressure to the wrist while resisting the movement. Pain at the inner elbow bump (medial epicondyle) indicates a positive result.

Also known as "Tennis Elbow", it's an inflammation of the tendons at the outer bony bump (lateral epicondyle) of the elbow. Overuse or repetitive motions are often the culprits.

Have the patient make a fist, pronate their arm (palm down), extend their wrist and fingers, then apply pressure to their extended fingers while resisting the movement. Pain at the outer elbow bump (lateral epicondyle) suggests a positive test.

Inflammation of the fluid-filled sac (bursa) located over the bony point of the elbow (olecranon). This can be caused by overuse, trauma, or infection.

A partial dislocation of the top part of the radius bone (radial head). It often happens in children when they are pulled by the hand or arm.

A break in the top part of the radius bone. It usually occurs from a fall on an outstretched arm.

A tear of the tendon that connects the biceps muscle to the forearm. This often occurs due to a sudden forceful contraction or injury.

A test for ACL tear. The examiner pulls the tibia forward while the knee is flexed at 90 degrees. Increased anterior gliding of the tibia suggests a positive result.

A test for PCL tear. The examiner pushes the tibia backward while the knee is flexed at 90 degrees. Increased posterior gliding of the tibia suggests a positive result.

A test for ACL tear. The examiner stabilizes the femur and pulls the tibia anteriorly while the knee is flexed at 20-30 degrees. Increased anterior gliding of the tibia suggests a positive result.

A test for MCL injury. The examiner applies a valgus force (abduction) to the tibia while the knee is extended or flexed at 20-30 degrees. Widening of the medial joint space suggests a positive result.

A test for LCL injury. The examiner applies a varus force (adduction) to the tibia while the knee is extended or flexed at 20-30 degrees. Widening of the lateral joint space suggests a positive result.

A test for meniscus tear. The examiner flexes the knee maximally, then rotates the tibia and applies valgus or varus stress while extending the knee. Pain indicates a positive result.

A condition where localized necrosis of the subchondral bone occurs due to repetitive trauma or stress.

An injury involving damage to the ACL, MCL, and medial meniscus. It often results from a lateral force applied to a planted leg.

An indication of knee effusion (fluid buildup) in the suprapatellar bursa.

A fluid-filled cyst that forms behind the knee, often associated with arthritis or a torn meniscus.

Repeated wrist flexion and forearm pronation.

Tenderness to palpation over the lateral epicondyle and pain with resisted wrist extension.

Tenderness to palpation over the medial epicondyle.

Repeated wrist extension and forearm pronation/supination.

Supraspinatus syndrome involves impingement of the supraspinatus tendon, while a rotator cuff tear is a complete or partial tear of the tendon.

Neer's test is used to assess for shoulder impingement. It involves forward flexion of the shoulder to greater than 90 degrees causing pain in impingement.

Hawkins-Kennedy test is used to assess for shoulder impingement. It involves forward flexion of the shoulder to 90 degrees followed by internal rotation, causing pain in impingement.

Yergason's test is used to assess for biceps tendon injury. It involves resisted supination of the forearm with the elbow flexed at 90 degrees. Pain suggests a biceps tendon injury.

Speed's test is used to assess biceps tendinitis. It involves resisted flexion of the shoulder in the scapular plane.

O'Brien's test is used to assess for a SLAP tear or AC joint pathology. It involves forced flexion at 90 degrees, adduction of 10 degrees, followed by resisted flexion with pronation and supination. Pain suggests a SLAP tear or AC joint pathology.

The Crank test is used to assess for a labral tear. It involves abduction of 90 degrees, axial load, and internal and external rotation. The presence of pain suggests a labral tear.

The Scarf test is used to assess the integrity of the AC joint. It involves adduction of the arm across the body. Pain at the AC joint suggests AC joint pathology.

The Sulcus sign is used to assess inferior shoulder instability. It involves pulling down on the adducted arm. A sulcus under the lateral acromion suggests inferior instability.

The Posterior Drawer Test is used to assess posterior shoulder instability. It involves increasing posterior translation of the humeral head relative to the glenoid. Increased posterior translation suggests posterior shoulder instability.

The Anterior Drawer Test is used to assess anterior shoulder instability. It involves increasing anterior translation of the humeral head relative to the glenoid. Increased anterior translation suggests anterior shoulder instability.

A malignant bone tumor originating from neuroectodermal cells, linked to chromosomal translocations of the EWSR1 gene on chromosome 22. Primarily affects the diaphysis of long bones, such as the femur, fibula, tibia, and humerus.

A small, benign bone tumor (<2 cm) located in the cortex of long bones. Responsive to NSAID (nonsteroidal anti-inflammatory drug) treatment.

A larger benign bone tumor (> 2 cm) located in the cortex of long bones. Unlike Osteoid Osteoma, it doesn't respond to NSAID therapy.

The most common primary malignant bone tumor in adolescents. Arises from mesenchymal stem cells, specifically osteoblasts. Typically found in the metaphysis of long bones, particularly the distal femur and proximal tibia.

The most common primary benign bone tumor. Characterized by a bony outgrowth (exostosis) with a cartilaginous cap, located near growth plates of long bones.

A benign bone tumor composed of giant cells derived from the bone marrow. Typically found in the epiphysis or metaphysis of long bones, especially around the knee.

A condition characterized by defective bone matrix mineralization, often due to Vitamin D deficiency. Symptoms include bone pain and tenderness.

A benign cartilage tumor located in the epiphysis of long bones.

The most common bone tumor in adults. A malignant bone tumor arising from mesenchymal stem cells specifically chondroblasts.

Benign tumors are non-cancerous, typically slow-growing, and don't spread. Malignant tumors, on the other hand, are cancerous, more aggressive, and can spread to other parts of the body.

This test assesses for cervical radiculopathy, or nerve compression in the neck. It involves extending the neck to the side of pain and applying downward pressure to the head. Pain radiating down the limb is a positive result.

This sign is associated with compression of the upper cervical spine or brainstem. It causes an electrical shock sensation down the spine and into the limbs when the neck is flexed, like the sensation you might get from an electric razor or a barber's chair.

This test is used to assess for lumbar nerve root impingement. It involves lying supine and raising the leg with the knee extended. Pain radiating below the knee suggests a positive result.

This refers to an excessive forward rounding of the upper back (thoracic spine). A normal kyphosis is between 20-40 degrees, but anything above 40 degrees is considered abnormal.

This type of fracture occurs spontaneously, often with minimal or no apparent trauma, and is caused by underlying bone weakness due to a medical condition.

This occurs when the inner core (nucleus pulposus) of an intervertebral disc pushes outwards through the outer ring (annulus fibrosus), often pressing on a nerve root.

This disease causes bone pain, fragility, and deformities. It's characterized by increased osteoclast activity, leading to excessive bone breakdown and then chaotic repair.

This is a condition where a vertebra slips forward over the one below it. It's caused by various factors, including congenital malformations, trauma, degenerative disease, and repetitive overuse.

This condition results in stiffening and fusion of the spine, causing limited movement and pain. A common genetic association is with the HLA-B27 gene.

This describes pain, numbness, or weakness in the arm and hand caused by compression of a nerve root in the neck.

Compression of the ulnar nerve in the wrist, causing weakness and numbness in the little finger and part of the ring finger.

Loose pieces of cartilage within a joint, often causing pain and mechanical symptoms like locking or catching.

A complete separation of the bones of the knee joint.

Repositioning a dislocated joint without surgery.

Repositioning a dislocated joint with surgery.

A ratio comparing the blood pressure in the ankle to the blood pressure in the arm.

Damage to the ligament on the inside of the knee.

Damage to the ligament in the middle of the knee that prevents the shinbone from sliding forward.

Damage to the ligament in the back of the knee that prevents the shinbone from sliding backward.

A test for anterior talofibular ligament (ATFL) injury. The examiner stabilizes the tibia, plantarflexes the foot, and applies anterior force on the heel. Increased laxity suggests an ATFL injury.

A test for calcaneofibular ligament (CFL) injury. The examiner stabilizes the tibia, dorsiflexes the foot, and inverts the foot. Increased laxity indicates a CFL injury.

A test for Achilles tendon rupture. The patient lies prone while the examiner squeezes the calf. Absence of foot plantarflexion suggests a ruptured Achilles tendon.

Inflammation of the plantar fascia, causing sharp pain at the heel, especially after prolonged weight-bearing or inactivity.

Joint destruction caused by loss of sensation and proprioception, often associated with diabetic neuropathy, leprosy, or alcoholism.

Flat foot caused by tibialis posterior tendon dysfunction.

Fluoroquinolone use, steroid injections, and sudden forceful movements can increase the risk of Achilles tendon rupture.

Patients often report a popping sensation during activity, followed by pain and difficulty plantarflexing the foot.

Anterior talofibular ligament (ATFL) sprain is the most common ankle sprain, typically occurring with ankle plantarflexion and inversion.

Acromioclavicular joint, the joint between the acromion (shoulder blade) and clavicle (collarbone).

Anterior cruciate ligament, a major ligament in the knee that prevents the tibia (shinbone) from sliding forward.

A tear in one or more of the muscles that surround the shoulder joint, collectively known as the rotator cuff. These muscles help stabilize the shoulder and allow for a wide range of movement.

A tear in the superior labrum of the glenoid (shoulder joint). The labrum is a ring of cartilage that helps stabilize the joint.

Inflammation of the tendons on the thumb side of the wrist, causing pain and difficulty moving the thumb.

A condition causing numbness, tingling, and pain in the hand and wrist due to compression of the median nerve in the carpal tunnel.

During a standing physical exam, the pelvis should elevate when one leg is lifted and the hip is flexed. If the pelvis falls, this suggests weakness in the gluteus medius muscle, which is innervated by the superior gluteal nerve.

A test for sacroiliac (SI) joint pathology. The hip is flexed, abducted, externally rotated, then abducted further. Pain in the hip during this maneuver suggests SI joint involvement.

A fracture of the scaphoid bone, a small bone in the wrist. It is a common injury from falls on an outstretched hand.

A condition that causes the fingers (usually the ring and pinky fingers) to bend inward and contract, making it difficult to straighten them.

Used to assess for hip impingement. The hip is flexed, adducted, internally rotated, then adducted further. Groin pain during this maneuver suggests hip impingement.

A test for arthritis in the hip. With the patient supine and the hip extended, the leg is internally and externally rotated. Pain in the hip during rotation suggests arthritis.

Inflammation of the trochanteric bursa caused by repeated tracking of the iliotibial band over the greater trochanter.

Slipping of the femoral metaphysis relative to the epiphysis.

Idiopathic avascular necrosis of the femoral head.

Hip instability, subluxation, or dislocation due to an abnormally developed, shallow acetabulum.

Trendelenburg gait is caused by weakness in the gluteus medius muscle.

The FADIR test is used to assess for hip impingement.