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My Hands are Aching, •Ordering imaging studies, such as x-rays or…

- - - - are
        
        8 Bones
        
        Arranged in 2 rows
  - - - supplied by the ulnar nerve except the
        3 thenar muscles and 2 lateral lumbricals
        
        exceptions supplied by Median Nerve
    - - Median n.: Lateral 2/3 of the palm + lateral 3 1/2 fingers + their nail beds
      - Ulnar n.: medial 1 /3 of the palm & dorsum of hand + medial 1 1 /2 fingers.
      - Radial n.: lateral 2/3 of the dorsum of hand + lateral 3 1 /2 fingers.
  - - - formed by
        
        mainly by the ulnar a. & the superficial br. of the radial artery.
- - - - • Wrist extension (radial nerve, C6, C7, C8)
      - • Wrist flexion (ulnar nerve C6, C7)
      - • Finger extension (extensor digitorum muscle, posterior interosseous branch of Radial nerve, C7, C8)
      - • Finger flexion (grasp) (flexor digitorum, superficialis & profundus muscles, median & ulnar nerves, C8)
      - • Finger abduction (1st dorsal interosseous muscle, ulnar nerve, T1 root)
      - • Finger adduction (2nd palmar interosseous muscle, ulnar nerve, T1 root)
      - • Thumb abduction with supinated forearm (abductor pollicis brevis muscle, median nerve, T1 root)
      - • Thumb adduction with supinated forearm (adductor pollicis C8, T1)
      - • Thumb opposition (C8, T1, median nerve)
- - - - classifications
        
        Ellipsoid
        
        type of joint in
        
        saddle
        
        type of joint in
        
        plane
        
        hinge
        
        pivot
        
        Ball and socket
        
        condyloid
        
        Knee
- - - - Local swelling, redness as well as pain
      - Stiffness following inactivity of a joint
      - Deformities of the hands and wrists
      - Extra-articular manifestations, for example, rheumatoid nodules, Sjogren's syndrome, pleurisy, vasculitis, peripheral neuropathy
  - - - NSAIDS
        
        NSAIDs vs DMARDS
      - Targeted syn. DMARDS
      - Steroids
      - Conventional DMARDS
        
        Examples
        
        *Methotrexate
        
        used for
        
        *Hydroxychloroquine
        
        *Sulfasalazine
        
        *Leflunomide
        
        *Minocycline
    - - Synovectomy
        
        Tendon repair
        
        Joint fusion
- - - - Colle’s fracture
        (dinner fork)
        
        Smith’s fracture (Garden spade)
        
        Jones fracture
        
        Boxer fracture
- - - - Helpful in diagnosing
        
        Carpal tunnel syndrome
        
        Sciatic nerve problems
        
        Herniated disk diseases
        
        Brachial plexopathy