Mind map

My Hands are Aching

ashraf Elsayed English

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My Hands are Aching

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