How to take a History of hand & wrist joint

When taking the history of a hand problem, consider:



* pain:

o pain from the hand may be felt in the fingers or palm

o a diffuse ache may be referred from the neck, shoulder or mediastinum



* deformity:

o as well as providing function the hand is also of great cosmetic importance

o deformity may occur acutely e.g. due to tendon rupture, or slowly due to bone or joint pathology



* swelling:

o symmetry and pattern of joint involvement may be diagnostic



* function:

o the patient may be unable to grasp doorknobs, turn keys or do buttons up



The history of the wrist joint should cover the following areas:



-Pain:

* often well localised in the wrist indicating particular disorders



-Stiffness:

* may be noticed only when severe



-Swelling:

* either of the joint or tendon sheaths



-Deformity:

* except in trauma, this is usually a late symptom





Easy carpal bones mnemonic: