Trigger finger [top]

  • Fixed flexion of ring or little finger
  • Click on forced extension of the finger
  • May have palpable nodule on flexor surface of finger

Rheumatoid arthritis [top]

  • Symmetrical deforming polyarthritis polyarthritis or monoarthritis Hand pain or deformity
  • Involvement of small joints of hands, wrists, knees knee pain
  • Morning stiffness
  • Can lead to severe deformities including swan-neck and boutonniere deformities
  • Usually RF+ve

Psoriatic arthritis [top]

  • May have other clinical features of psoriasis including nail pitting. Usually RF-ve.
  • Assymetric: Monoarthritis or oligoarthritis
  • Symmetrical deforming polyarthritis polyarthritis particularly distal interphalangeal joints hand pain or deformity
  • Rheumatoid-arthritis like
  • Arthritis mutilans
  • Ankylosing spondylitis-like

Dupuytren's contracture [top]

  • Progressive flexion deformity with prominent fibrotic band affecting little and ring fingers
  • Risk factors: Familial, excessive alcohol consumption, antiepileptics

Volmann's ischaemic contracture [top]

  • Flexion deformity of muscles of the forearm due to brachial artery ischaemia
  • Acutely presents as cold, pulseless arm with pain on finger extension
  • Risk factors: Supracondylar fracture of humerus, Surgery adjacent to brachial artery, tight cast

Ganglion [top]

  • Painless, fluctuant swelling adjacent to wrist joint
  • Reduces in size with pressure