Hand and wrist disorders

The hand and wrist are linked by disease processes. A medical examination is needed to determine the cause and carry out treatment. Diagnostic ultrasound, X-rays and laboratory tests are often essential to establish the diagnosis as quickly as possible. Ligaments, nerves, tendons, joints and bones are susceptible to many disease processes. Injuries cause partial or complete tears of ligaments and tendons, haematomas and other post-traumatic damage. Overuse syndromes and inflammatory and degenerative diseases cause changes in bony structures, such as osteophytes, while in the nerves median and ulnar neuropathies develop, with marked tingling, weakness and muscle wasting. Injuries to the extensor and flexor tendons of the fingers often need to be detected as soon as possible, and diagnostic ultrasound helps with this. Cystic swellings in the hand cause pain as well as cosmetic concerns. By evaluating such swellings we find ganglion cysts, effusions, synovitis and tenosynovitis.

In inflammatory rheumatic diseases, we can find inflammatory or metabolic arthritis in the hand, the most common being rheumatoid arthritis, peripheral manifestations of spondyloarthritis, psoriatic arthritis, various forms of enthesitis, and also metabolic diseases such as gout and pseudogout. The most common changes in the hands are degenerative, such as osteoarthritis (arthrosis), which shows as nodules on the joints of the hand: Bouchard's nodes form on the proximal interphalangeal joints, while Heberden's nodes form on the distal interphalangeal joints. Overuse syndromes can cause carpal tunnel syndrome, as well as tenosynovitis of the thumb abductor and extensor, known as de Quervain's disease. Trigger finger is a thickening of the finger flexor tendon and of the annular pulley, which prevents the tendon from gliding through its canal; the tendon catches, limiting movement and causing pain and weakness, often with an audible click. Dupuytren's contracture affects the structures of the palm, especially the palmar aponeurosis, and presents as a palpable mass, diffuse fibrosis or a nodular change.

You can turn to our specialist doctors with confidence – they will help you.