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Gross clubbing – Thickening of the whole distal (end part of the) finger (resembling a drumstick) Hypertrophic osteoarthropathy – Shiny aspect and striation of the nail and skin; Schamroth's sign or Schamroth's window test (originally demonstrated by South African cardiologist Leo Schamroth on himself) [16] is a popular test for clubbing.
The middle phalanges' (often those of the 2nd, 3rd and 5th digits of the hands) angel shape is caused by an abnormal development of the epiphysis, metaphysis, and diaphysis of said phalanges; the wings are formed by an abnormal dyaphysis, the angel's skirt is from a cone-shaped epiphysis, and the head is formed by an abnormal distal pseudoepophysis.
abnormal plantar reflex: Kumar SP, Ramasubramanian D (December 2000). "The Babinski sign—a reappraisal". Neurol India. 48 (4): 314– 8. PMID 11146592: dorsiflexion of the hallux with fanning of the remaining phalanges upon soft stimulation of the lateral plantar surface of the foot Bainbridge reflex: Francis Arthur Bainbridge
PDP has a number of visible signs. Most important clinical features are: pachydermia (thickening and wrinkling of the skin), furrowing of the face and scalp, periostosis (swelling of periarticular tissue and shaggy periosteal new bone formation of long bones) and digital clubbing (enlargement of fingertips). [1]
Hypertrophic osteoarthropathy is a medical condition combining clubbing and periostitis of the small hand joints, especially the distal interphalangeal joints and the metacarpophalangeal joints. Distal expansion of the long bones as well as painful, swollen joints [ 3 ] and synovial villous proliferation are often seen.
Upper & lower extremities are affected with chronic ulcerations and multiple injuries to fingers and feet. Pain sensation is affected predominantly and deep tendon reflexes are reduced. Autoamputation of the distal phalanges is common and so is neuropathic joint degeneration.
Pycnodysostosis also causes problems that may become evident with time. Aside from the broken bones, the distal phalanges and the collar bone can undergo slow progressive deterioration. Vertebral defects may permit the spine to curve laterally resulting in scoliosis. The dental problems often require orthodontic care and cavities are common.
If a jammed finger produces a fracture, pain will be greatest at the bone as opposed to the joint. [2] There may also be visual deformation of the bone itself. [6] As with any skeletal injury, an x-ray can be conducted to verify the presence of a fracture. [1] The distal phalanx is especially vulnerable to avulsion fractures. [1]