Common Complaints and DDx

Key Signs

Introduction

• Hand wash
• Name
• Explain exam to the patient: I will be examining your wrist and hands, and testing hand movements.
• Vitals
• General Insection

Position

• Arm holding up (palm not supported)

Draping

• N/A

Inspection

• Dorsal and palmar aspects

  • SEADS
  • asymmetry, malalignment, contractures
  • Effusions, nodules

  Location	Specific Signs	Conditions
  Dorsal and palmar aspects	Shiny, tight or thickened skin
  ‣	‣
  	‣	Inflammation, ‣
  MCP	‣, ‣	Inflammation, ‣
  PIPs/DIPs	loss of skin creases and fusiform swelling	‣
  	‣, ‣	OA - Osteoarthritis
  	‣, ‣	‣
  	‣	‣
  Nails		‣
  Any locations	Synovial tickening	‣

Palpation

Look for: Joint Effusion

<aside>

Feel free fluid in joint using 2 thumbs

• one thumb pushes

• the other thumb feel </aside>

• Palm