My Hands are Aching

My Hands are Aching

1. Complaint: Pain and swelling in the wrist and metacarpalphalyngeal joint

   • Anatomy of the hand
     • Bones and joints and ligaments
       • they also make the carpal tunnel
         • • compression of the median nerve results in carpal tunnel syndrome
             • • Symptoms
                 • Numbness, tingling and pain
               • Treatment
                 • NSAIDs, splinting and in severe cases surgery
               • Causes
                 • Anything that leads to the compression of the median nerve
                   • Pregnancy, diabetes, inflamation, fractures etc.
       • Synovial joints containing synovial fluid
         • Ultrafiltrate from the plasma
           • Containing several substance such as
             • Hyaluronan
               • Main reason for viscosity and rheopexy
             • Lubricin
               • Secondary lubricant for borders
         • Main functions
           • Lubrication
           • Shock absorbtion
           • Transportation of nutrients and wastes
           • Filtration
     • Muscles
     • Nerves
     • Blood supply
     • Bursae
   • Differential diagnosis
     • Arthritis
       • Types
         • Osteoarthritis
         • Gout arthritis
         • Psoriatic arthritis
         • Rheumatoid arthritis
           • Pathophysiology
           • Signs and symptoms
           • Radiographic features
             • Early
               • Soft tissue swelling
               • Juxtaarticular osteoporosis
                 • Joint space narrowing
             • Late
               • Ulnar deviation of the joints/sublaxation
           • Complications
             • Anemia
             • Lymphoma
             • Peripheral neuropathy
           • Risk factors
           • Investigations using
             • CBC
             • Serum antibodies
             • Inflammatory markers
             • X-rays
           • Treatment
             • NSAIDs
               • Aspirin and Ibuprofen
             • DMARDs
             • Biological therapis
               • • TNF inhibitors
                 • Non TNF inhibitors
             • Physiotherapy
             • Rehabilitative treatment
     • Fractures
     • Infections
   • Examination

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