Tuesday, June 15, 2010

How to take a History of hand & wrist joint

When taking the history of a hand problem, consider:

* pain:
o pain from the hand may be felt in the fingers or palm
o a diffuse ache may be referred from the neck, shoulder or mediastinum

* deformity:
o as well as providing function the hand is also of great cosmetic importance
o deformity may occur acutely e.g. due to tendon rupture, or slowly due to bone or joint pathology

* swelling:
o symmetry and pattern of joint involvement may be diagnostic

* function:
o the patient may be unable to grasp doorknobs, turn keys or do buttons up

The history of the wrist joint should cover the following areas:

* often well localised in the wrist indicating particular disorders

* may be noticed only when severe

* either of the joint or tendon sheaths

* except in trauma, this is usually a late symptom

Easy carpal bones mnemonic:

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