– Discussion: – its essential to consider the differential dx and to examine the patient from the neck down to the finger tips; – in taking the history, be sure to inquire as to whether the patient’s main complaint is hand/wrist pain versus paresthesias; – it is also important … Read more
– Neurological Exam: – be sure to examine the AIN, PIN, and median nerve at the wrist; – carpal tunnel syndrome; – evaluate the strength of the APB; – injury from contact with bone spicules; – … Read more
– Discussion: – pt w/ anterior dislocation keep affected arm at side of body in external rotation; – shoulder will loose its usual roundness and will be full anteriorly to palpation; – axillary nerve f(x) should be documented; – rotator cuff is frequently damaged & should be … Read more
– See: neuropathic disorders and neuropathic ulceration – Discussion: – neuropathies may be either acute or chronic; – acute: – Guillain Barre syndrome: best known acute neuropathy; – vasculitic neuropathy: – random involvement of … Read more
– See: – Carpal Instability – Ligaments of the Wrist – Discussion: – perilunate dislocation pattern provides a whole spectrum of wrist sprains, fractures, dislocations; – types of perilunate dislocations (in order of frequency): – transscaphoid-perilunate … Read more
– See: – Green Stick Fractures – Pediatric Distal Radius Fracture – Pediatric Ulnar Fracture – Discussion: – frx may be of green stick type or complete (latter may be undisplaced, minimally displaced, or markedly displaced w/ overridding); – frx … Read more
(see: juvenile RA menu) Discussion definition: < 4 involved joints. most frequently encoutered subgroup, accouting for 30-40% of JRA; peak age is 2-4 years more common in girls (4x) differential dx Clinical Presentation> begins w/ incidious onset which can be painless swelling, warmth, and restriction of motion are common sx; knee, ankle, and elbow (& … Read more
– See: – Rheumatoid Boutonniere – Thumb Boutonnere Injuries – Mechanism of Injury: – rupture of central slip directly from its bony insertion commonly results from closed blunt trauma (w/ or w/o fracture); – rheumatoid Arthritis – volar PIP dislocation – … Read more
– Discussion: – potential space between FPL tendon, FDP tendons, & pronator quadratus; – is known as the subtendinous space of the wrist or Parona’s space; – pus in FPL sheath can ascend in the radial bursa and eventually rupture into this space; – pus in little … Read more
– Discussion: – palmar cutaneous branch of median nerve arises from radial border of median nerve approximately 5 to 6 cm proximal to distal transverse flexion crease of the wrist; – it runs along the median nerve for 2 to 3 cm, and then runs along the ulnar border of the flexor carpi … Read more