Rheumatoid Arthritis Hand Physical Exam OSCE Prep
Автор: Evan Graham
Загружено: 2020-11-24
Просмотров: 2339
Описание:
Rheumatoid hand Royal College OSCE review: of note this is not sponsored or reviewed by the Royal College, but meant to help with physical exam preparation.
Inspection
: synovitis
, swelling & erythema, ulnar or radial deviation,
volar subluxation of the carpus,
Loss of carpal height, prominent ulnar styloid, intrinsic muscle atrophy
, rheumatoid nodules, prominence of extensor tendons
, palmar erythema
, tethered skin,
swan-neck deformity
, Boutonnière deformity, Boutonnière-like deformity (Z-shaped thumb), pincher grasp,
periungual infarct of nails
Palpation
:
Feel for warmth & watch for tenderness.
Balloon sign. Synovial thickening. Check to see if deformities are reducible. Cysts from volar aspect of wrist, rheumatoid nodules,
tenosynovitis of flexors, thickening of palmar tendons
Functional Assessment
: Range of Motion
- see video. Try to burry finger nails in palm (normal)
.
Initially active ROM then test passive
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