Hand and Wrist Disorders

A ganglion cyst is a type of malignant tumor found in the hand.

27 year old patient presents with an infection in the closed tip of the anterior second phalanx. How would you present this to a medical officer?

Which is NOT a sign of septic tenosynovitis?

You would use Kanavel's cardinal signs in order to identify a septic tenosynovitis.

A patient is diagnosed with a felon. After incision and drainage, you would prescribe an antibiotic in order to combat what bacteria? 1. Streptococcus 2. MRSA 3. Rickettsia 4. Staphylococcus aureus

"Trigger finger" is a non-acute, idiopathic condition in a phalanx in which a patient has extension but not flexion.

Carpal tunnel syndrome is an idiopathic condition that involves entrapment of the:

26 year old male supply clerk (POG) complains of pain and numbness in his first (pollux), second, and third phalanxes. As a learned doctor, you suspect carpal tunnel syndrome due to his weak genes and excessive use of a computer. What would you do to confirm your diagnosis? 1. Finklestein 2. Tinel 3. Colle's 4. Phalen

What kind of hand injury may look minor but requires immediate referral to a specialist for surgical intervention in order to avoid amputation or even death?

Common nerve injuries can include: 1. Radial nerve palsy 2. Ulnar nerve palsy 3. Median nerve palsy 4. Crutch palsy

Delayed reporting and/or lying is a major problem when treating De Quervain's tenosynovitis.

21 year old male Marine complains of severe pain in a hand injury he suffered over the weekend in a bar brawl. You notice jagged soft tissue damage near his second metacarpophalangeal (MCP) joint and is holding his finger in extension. What condition is this most indicative of?

Enteral (oral) antibiotics is the gold standard treatment of septic tendonsynovitis.

De Quervain's tenosynovitis is a condition which involves the tendon of what muscle? 1. Abductor pollicus longus 2. Extensor carpi radialis longus 3. Extensor pollicus brevis 4. Flexor carpi ulnaris

43 year old female patient presents with pain and tenderness that radiates up her forearm and down to her thumb. You perform and confirm a positive Finklestein test. What would you diagnose in this patient?

Dislocation of a metacarpophalangeal (MCP) joint usually requires surgery to properly treat.

Gamekeeper's thumb would be classified as what type of injury? 1. Scaphoid fracture 2. Chronic injury 3. "Silver fork" deformity 4. Ulnar collateral ligament (UCL) rupture

Upon reviewing an MRI from a 34 year old patient with a traumatic hand injury, you discover a rupture of the ulnar collateral ligament. What could you also call this condition?

The indicative treatment for an ulnar collateral ligament (UCL) rupture includes a thumb spica splint.

How would you anatomically describe a mallet finger?

How would you properly treat an avulsion fracture of the distal phalanx? 1. Reduction to prevent compartment syndrome 2. Splint DIP in hyperextension for 6 weeks 3. Sugar tong splint for 2 weeks 4. Educate patient to leave splint on long enough

What obvious visual sign would you expect to see in a patient with a volar plate fracture? 1. Swan-neck deformity 2. Hyperextended PIP 3. Flexed DIP 4. Volar angulation

A Wilson fracture is a volar plate avulsion of the base of the middle phalanx.

The most common metacarpal fracture, also known as a "boxer fracture", will commonly present with what sign or symptom? 1. External rotation 2. Injury is usually to fifth phalanx 3. Fracture occurred in distal neck of the metacarpal 4. Volar angulation

A boxer fracture is commonly treated with an ulnar gutter splint.

A 55 year old male presents with pain in his fourth phalanx. Using inspection, palpation, and radiography: you assess that there is a dislocation of the finger at the metacarpal joint. What is this commonly known as?

A Rolando fracture is simply a comminuted Bennett fracture.

Avascular necrosis secondary to trauma and a non or mal union is a very concerning sign most likely found in what hand injury?

After properly diagnosing a wrist injury as a scaphoid fracture, what is the most appropriate treatment?

You would repeat x-ray views in 10-14 days if they are negative for a scaphoid fracture.

A 104 year old man suffers a hand injury secondary to trauma while trying to catch himself during a fall. Upon inspection, you note a "silver-fork" deformity at the distal radius and dorsal angulation of the hand. These signs would lead you to believe the diagnosis of this patient would be:

A forearm sugar tong splint is indicated in displaced fractures in regards to the treatment of injuries in the distal radius.

A 23 year old Airman complains of severe wrist pain after suffering a fall on the dorsum of his hand due to wine coolers and limp wrist syndrome. In addition to this classic MOI, you also discover voller (palmer) angulation. What would you diagnose this as?