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5 - Examination of the hand

Joe A. Garcia
Affiliation:
Chesterfield Royal Hospital
Nick Harris
Affiliation:
Department of Orthopaedic Surgery, Leeds General Infirmary
Fazal Ali
Affiliation:
Department of Orthopaedic Surgery, Chesterfield Royal Hospital
Mark D. Miller
Affiliation:
James Madison University, Virginia
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Summary

Examination of a patient’s hand should always follow a comprehensive history. This provides valuable information to determine a diagnosis and to assess the impact that symptoms have on the patient’s daily functions. Always remember to ask for hand dominance, occupation and recreational activities.

The following hand examination can confirm the working diagnosis or may raise possible alternative diagnoses. It may be used to assess a patient’s hand function. Observations made from the history and examination may have an impact on the treatment options available.

There are numerous pathologies in the hand, which makes a standard approach helpful. By looking, feeling and assessing movement we can be sure of picking up most of the significant clinical findings. Special tests for individual pathologies may then complete the examination.

Screening

After exposing the upper limb adequately a screening examination is performed. Screening is an extremely important part of the examination, as close inspection whilst this is carried out will reveal clues to virtually all pathologies in the hand.

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