Common upper extremity problem

stenosing tenosynovitis

-         -          De Quervain disease

-        -           Extensor carpi ulnaris (ECU) tendinitis (reverse De Quervain disease)

-        -           Trigger finger

De Quervain disease

-     -              first extensor compartment

  • abductor pollicis longus (APL)
  • extensor pollicis brevis (EPB)

-       -            Sign and symptoms

  • tenderness : radial styloid
  • Finkelstein’s test

-        -           Differential diagnosis

  • Fracture scaphoid , Fractureradius

-      -             Treatment

  • Thumb brace
  • NSAIDs
  • local steroid injection
  • decompression of the first extensor compartment

Extensor carpi ulnaris (ECU) tendinitis (reverse De Quervain disease)

-       -            Sign and symptoms

Trigger Finger

-       -            A1 pulley

-      -             Sign and symptoms(4stage)

  • Inflammation
  • Triggering
  • Locking
  • flexion contracture

-     -              Treatment

  • NSAIDs
  • local steroid injection
  • A1 pulley release( Open , Percutaneus)

 

ganglion cyst

-                   Pathophysiology

  • partial thickness injury
  • mucoid degeneration

-        -           Sign and symptoms

  • Transillumination

-     -              Treatment

  • Observe
  • manual reduction , needle rupture
  • Excision

entrapment neuropathy of the upper extremity

carpal tunnel syndrome

-          -         Pathophysiology

  • transverse carpal ligament (flexor retinaculum)

-       -            Sign and symptoms

  • nocturnal pain
  • lateral thenar atrophy
  • Phalen’s test, Tinel’s test, abductor pollicis brevis power
  • Sensation

-       -            electrodiagnostic study

-          -         Treatment

  • Medication
  • nerve stretching exercise
  • Local steroid injection
  • Carpal tunnel release

cubital tunnel syndrome 

-          -         Ulnar nerve

-           -        Sign and symptoms

  • Tinel’s test
  • elbow flexion test
  • claw hand
  • Sensation

-         -          Investigation: X-ray elbow

-         -          Treatment

  • Medication
  • Local steroid injection
  • Surgery

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