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The cases
Published in Chris Schelvan, Annabel Copeman, Jacky Davis, Annmarie Jeanes, Jane Young, Paediatric Radiology for MRCPCH and FRCR, 2020
Chris Schelvan, Annabel Copeman, Jacky Davis, Annmarie Jeanes, Jane Young
There is soft tissue swelling around the wrist. The bones are osteopenic. The carpal bones are small and irregular, with multiple erosions. There are further erosions of the bases of the second, third and fourth metacarpals and of many of the small joints. There is loss of the joint space at the radiocarpal and intercarpal joints.
Fundamentals
Published in Clare E. Milner, Functional Anatomy for Sport and Exercise, 2019
The least mobile type of synovial joint is a gliding (arthrodial) joint. This joint has flat articular surfaces and only allows short gliding or sliding movements between them. Examples include intervertebral, intertarsal and intercarpal joints.
The wrist
Published in Ashley W. Blom, David Warwick, Michael R. Whitehouse, Apley and Solomon’s System of Orthopaedics and Trauma, 2017
Total arthrodesis of the wrist This is occasionally necessary. The radiocarpal and intercarpal joints are decorticated, bone graft is impacted and a plate is fixed to the third metacarpal and the distal radius. Contouring the plate to 15 degrees of dorsiflexion improves grip strength.
Conservative management of De Quervain’s tendinopathy with an orthopedic manual physical therapy approach emphasizing first CMC manipulation: a retrospective case series
Published in Physiotherapy Theory and Practice, 2022
Scott W. Young, Thomas W. Young, Cameron W. MacDonald
There is evidence that manual therapy interventions can be beneficial when treating patients with hand and wrist impairments. A case report found that radiocarpal and intercarpal joint mobilization was effective in treating a patient with radial wrist pain (Walker, 2004). A pilot study demonstrated that radiocarpal and scapholunate mobilization improved outcomes in the hemiplegic hand of patients post-stroke (Smedes, van der Salm, Koel, and Oosterveld, 2014). Median and radial nerve mobilization was found to be effective in treating patients with first carpometacarpal (CMC) osteoarthritis (Villafane, Silva, Bishop, and Fernandez-Carnero, 2012; Villafane, Silva, and Fernandez-Carnero, 2011). A randomized controlled trial determined that a combination of joint mobilization, neural mobilization, and exercise was effective in treating patients with thumb CMC osteoarthritis (Villafane, Cleland, and Fernandez-de-las-Penas, 2013).
Manual therapy for work-related wrist pain in a manual physical therapist
Published in Physiotherapy Theory and Practice, 2021
Alexandra R. Anderson, Craig P. Hensley
The patient presented with ulnar-sided wrist pain and a history of wrist instability and pain. Current complaints were postulated to be a result of repetitive non-thrust techniques to patients’ lumbar and thoracic spine, which had become problematic 6 months prior to evaluation. The clinical impression was LT joint pain secondary to repetitive microtrauma from her gymnastics history and current repetitive performance of manual therapy. Some pathologies could not be ruled out completely after the exam. For instance, Kienböck’s disease, or avascular necrosis of the lunate, requires imaging to make a diagnosis, but the patient had no systemic diseases that would increase her risk (Porteous, Harish, and Parasu, 2012). If conservative management failed, radiographs and/or further medical workup could be ordered to assist in the diagnosis process. Mobility at other intercarpal joints was deemed a contributing factor. The mechanism of injury from performing manual therapy was described in a position of repetitive wrist extension with compressive forces through the ulnar-side of the wrist.
Tofacitinib‐induced subacute cutaneous lupus erythematosus in a patient with rheumatoid arthritis
Published in Modern Rheumatology Case Reports, 2021
In the laboratory evaluation of the patient, the hemogram and biochemistry test results were within normal limits: urinalysis: normal, erythrocyte sedimentation rate (ESR): 48 mm/h (0–20); C-reactive protein (CRP): 15 mg/dL (0–5); rheumatoid factor: 11 international unit(IU)/mL (0–15); anti-cyclic citrullinated peptide (CCP) antibody: 5 IU/mL (0–20); brucella rose bengal: negative; hepatitis B surface antibodies (anti-HBs): 52 IU/mL (0–10); antinuclear antibodies (ANA) titre: 1/100 (weak positive); extractable nuclear antigens (ENA) and anti-double stranded deoxyribonucleic acid (anti-dsDNA) negative; total cholesterol: 220 mg/dL (0–199); low-density lipoprotein (LDL) cholesterol: 126 mg/dL (<130) ; high-density lipoprotein (HDL) cholesterol: 48 mg/dL (35–65); triglyceride: 230 mg/dL (0–150) and disease activity score 28 ESR (DAS28-ESR): 6.1. In the hand radiography, narrowing of the intercarpal joints and increased sclerosis were detected in both hands (Figure 1).