Hand (standard tests and special tests)

Case 5

You are working as a 5th-year student at a general practitioner office. The next patient is a 25-year-old man. He went on a ski trip three days ago, fell on a steep downhill. He caught himself with his left hand. Gradually, he developed pain in the left thumb region.

Hand examination

• Perform standard hand examination
  • Inspection
  • Active movement
  • Passive movement
  • Isometric movement
  • Palpation

Inspection of the hand

Active movements of the hand

Passive movements hand

Isometric movements hand

Palpation hand

Clinical findings

On examination, you find tenderness in the left thumb located around the thumb's metacarpophalangeal joint (MCP joint). Slight swelling in the area. Pain when using the pinch grip.

Which special tests would you perform to strengthen or weaken your tentative diagnosis?

Case 6

You are working as a fifth-year medical student at a general practitioner's office. The next patient is a healthy 35-year-old woman. She works in an office and is currently on maternity leave. She gave birth four months ago and is breastfeeding her child. Over the past month, she has developed pain in her right wrist and has difficulty holding her child while nursing. No history of injury.

Hand examination

Perform relevant special tests to strengthen or weaken your tentative diagnosis.

De Quervain's tenosynovitis

Cartilage injury ulnar wrist (TFCC)

Scaphoid fracture

Neurovascular status of the hand

Clinical findings

Upon examination, you note a slight swelling on the radial side of the right wrist region. No redness or warmth. Normal range of motion in the wrist. Normal strength performance in all muscle groups. She reports tenderness on palpation over the radial styloid process.

Cases