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HAND
Duputryens Contracture
Dupuytren’s Contracture is a hand condition that gradually causes the fingers to bend inward due to thickening of the tissue under the skin of the palm.
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Definition: A progressive condition where the fascia (connective tissue) in the palm thickens and tightens, pulling fingers—usually the ring and little fingers—into a bent position.
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Causes: Exact cause is unknown; linked to genetic factors and abnormal wound healing response in the palmar fascia.
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Types / Progression:
~ Nodules: Small lumps form in the palm
~ Cords: Fibrous bands extend to fingers
~ Contracture: Fingers bend and can't fully straighten
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Symptoms: Painless nodules in the palm, thickened cords, difficulty straightening fingers, hand stiffness.
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Diagnosis Tools: Physical examination; table top test (inability to place palm flat on a surface).
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Risk Factors: Family history, age (over 50), male gender, Northern European descent, diabetes, alcohol use, smoking.
Rheumatoid Arthritis Deformities
An autoimmune disease causing chronic joint inflammation and damage, resulting in finger and hand deformities.
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Definition: Autoimmune disease that causes joint inflammation, gradually damaging cartilage and bone, resulting in visible hand and finger deformities.
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Causes: Autoimmune attack on joint tissues, leading to chronic inflammation and joint erosion.
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Common Deformities:
~ Swan Neck Deformity: Hyperextension of PIP joint and flexion of DIP joint.
~ Boutonnière Deformity: Flexion of PIP joint and hyperextension of DIP joint.
~ Ulnar Deviation: Fingers drift toward the little finger side.
~ Z-Thumb Deformity: Flexed MCP joint and hyperextended IP joint
~ Joint Subluxation: Partial dislocation of joints.
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Symptoms: Joint pain, stiffness (especially in the morning), swelling, reduced range of motion, visible deformity, and hand dysfunction.
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Diagnosis Tools: Physical exam, X-rays, blood tests (RF, anti-CCP).
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Risk Factors: Female gender, age (30–60), genetics, smoking, and autoimmune predisposition.
