Arcuate finger

Introduction The arched finger is an arched buckling of the finger to the volar side. The arched finger is one of the early symptoms of Kashin-Beck disease. Kaschin-Beck disease is a kind of endemic deformity osteoarthrosis. It is also called dwarf disease and abacus disease in China. The international medical profession calls this disease Kaschin-Beck disease. Kaschin-Beck disease is mainly distributed in eastern Siberia and northern North Korea. It is widely distributed in China and is mostly distributed in mountainous areas and semi-mountainous areas. Plains are rare. The disease occurs in all age groups, but it occurs mostly in children and adolescents. Adults rarely develop disease and there is no obvious gender difference.

Cause

The cause of arthropathy is still unknown. It was suspected to be caused by chronic poisoning of the mouth, but it was not confirmed. Most people think it may be related to pathogenic mold in the grain.

an examination

Related inspection

Joint examination posture and gait bone and joint soft tissue CT examination

Early performance

Early symptoms and signs are often lacking in characteristics before the joints become significantly larger and short finger (toe) deformities appear. According to a large number of investigations and follow-up observations, the following performances deserve attention

(1) joint pain: often multiple, symmetrical, often appear in the large amount of knuckles and large weight of the knee, ankle joint. The patient feels pain, soreness or "stomach pain."

(2) refers to unbending bending: that is, the end knuckles of the 2nd, 3rd, and 4th fingers are bent toward the palm of the hand, often greater than 15o. This is the earliest sign of the disease, and it has certain significance in the early diagnosis of the diseased area. However, a small number of children in non-ward areas may also have a lesser degree (less than 15o) of the bending of the fingertips; the disease may occur in adolescents with no bending in the ward. The bending of the fingertips often coexists with the fingers. The skew is more common with the index finger, followed by the middle finger and the ring finger.

(3) Arched fingers: the fingers are bowed to the volar side.

(4) Condensed knuckle thickening: generally occurs in the middle section.

2. Performance after the development of the disease

After the disease progresses, the early symptoms such as joint pain continue to increase, mainly the following symptoms and signs appear:

(1) joint thickening: the most common is the multiple, symmetrical interphalangeal joint thickening, often first appeared in the second, third and fourth fingers of the first interphalangeal joint. Generally, the thickening of the right finger joint is more obvious than that of the left hand, and the joint of the mechanically injured joint or the woman with the thimble is thicker and heavier.

(2) Joint movement disorder: In the hand, it shows that the fist is stiff in the morning, the fist is not tight, the fingertip can't touch the palm horizontal stripes, and the fist can not be stretched quickly. The elbow joint is limited in flexion and extension and is flexed and contracted. When the shoulder joint is involved, the patient can't touch the opposite side of the ear with his hands, and even wash his face without washing his forehead. Knee inversion or eversion, in the form of a looped leg or a scissor-shaped leg. Due to the flexion and deformation of the knee and hip joints, the patient has difficulty in squatting, compensatory lordosis of the lumbar spine, kyphosis of the hips, small stride when walking, swaying or abduction, showing "gait gait", ankle joint flexion and Back stretch obstacles. The patient's pain and movement disorders often manifest as aggravation after a break or morning, and a slight reduction in activity. After many patients have started in the morning, they need to step on the bed to "squat" and then take a step.

(3) Joint friction sounds: ranging from small sounds to rough friction sounds. Due to factors such as uneven joint surface, hyperplasia and shedding of synovial villi in joint capsule.

Differential diagnosis

Differential diagnosis of the bow finger:

1, clubbing (toe): refers to the (toe) end of the soft tissue thickening like a drum-like expansion, arched bulge, a longitudinal ridge and transverse ridges are highly curved, the surface is glassy, called the clubbing (acropachy. Clubbing finger). Also known as the faded finger. The angle between the side nail and the nail skin of the healthy person's finger is 160 degrees. With the occurrence of the forest finger, the angle can be gradually increased to 180 degrees or more. Pressing the root of the nail can have a noticeable elasticity and tenderness. The finger-like fingers appearing in different diseases have different fingertip colors. The forest finger of the congenital heart disease of the hair group, the finger is often purple and black, the nail arc is reddish brown, the capillary of the nail bed is increased, and the blood flow at the finger end is increased. In patients with lung disease, the fingertips of the forest finger are dry and not smooth, yellowish white, and the blood vessel proliferation is not significant. Oral refers to the more common symptoms of certain diseases in the internal medicine.

2. Giant finger (toe): Giant finger (toe) is a congenital malformation characterized by an increase in the volume of the fingers or toes. The incidence in congenital malformations of the extremities is very low, about 0.9%.

3, knuckles thickening: the clinical manifestations of Kaschin-Beck disease: condensed knuckles thickening, generally occurs in the middle section.

4. Hypertrophy of the phalanx: Pachyermoperiostosis is also known as hypertrophic periosteal hyperosteogeny and Touraine-Solente-Gole syndrome. The primary may be autosomal dominant. Secondary is also called hyperproliferative osteoarthrosis. Often secondary to a variety of chronic and malignant neoplastic diseases. The pathogenesis is still unclear. Primary: more common in men, often soon after puberty. Secondary: After the middle age, the disease is more common in women, and the skin cannot change. It can be diagnosed based on typical changes in skin and bone.

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