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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.
Hitchhiker's thumb, also known as distal hyperextensibility of the thumb, is the condition of having a thumb that has a distal phalange that bends backwards in an angle of 90°. This condition is benign (when isolated) and does not cause pain or affect the thumb with the trait negatively.
This deformity is caused by a widening of the epiphyseal plate of the fifth finger's distal phalange. [12] Another proposed cause involves the abnormal insertion of the flexor digitorum profundus in the volar area of the fifth finger's distal phalange. [13] It is thought to be an autosomal dominant trait with reduced penetrance. [14]
Swan neck deformity has many of possible causes arising from the DIP, PIP, or even the MCP joints. In all cases, there is a stretching of the volar plate at the PIP joint to allow hyperextension, plus some damage to the attachment of the extensor tendon to the base of the distal phalanx that produces a hyperflexed mallet finger.
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]
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.
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]