Fingers askew

Introduction An oblique finger refers to a skewed deformity on the side of the finger that can occur on any finger, tilting toward the ankle or ulnar. Most occur at the distal end of the little finger and point to the metatarsal side of the joint. The pathological changes that occur in the bones are very similar to those of the large joint disease. It has been reported that the incidence rate is between 1% and 19.5%.

Cause

(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.

an examination

Related inspection

Joint examination of bone and joint soft tissue CT

The malformation can be one of the signs of certain syndromes, with more than 30 syndromes and more with such malformations. Often combined with and refers to, short finger deformity and so on.

(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.

Differential diagnosis

The diagnosis should be differentiated from various finger malformations:

1. Flexion refers to: flexion refers to the change of flexion deformity of the finger, the flexion of the finger, often family history, the beginning is not obvious, gradually worsening, often accompanied by other systemic syndromes such as Doun syndrome.

2. Thumb adduction malformation: Clinical manifestations of sacral nerve injury in exercise: When the upper arm sacral nerve is injured, each extensor muscle is extensively sacral, triceps, diaphragm, sacral long extensor, supinator, and extension Refers to the total muscle, ulnar wrist extensor muscles and the index finger, the small intrinsic extensor muscles of the little finger. Therefore, the wrist is drooping, the thumb and each finger are drooping, and the knuckles cannot be extended. The forearm has a pronation deformity, can not be rotated, and the thumb is deformed.

3. Three sections of thumb: Polydactyly is the most common congenital malformation of the hand, which occurs mostly in the temporal side of the hand, sometimes combined with other deformities. Clinically, it can be divided into three types: 1 excess finger has only soft tissue and no bone. 2 There are some phalanx and part of the tendon in the excess finger, which is a finger with functional defects. 3 has a complete palm and phalanx, and the function is also complete, it is difficult to distinguish which finger is multi-finger. Wassel divided the temporal side into seven types: type I, distal phalanx bifurcation; type II, distal phalanx completely repeated; type III, distal phalanx repeat; type IV, proximal phalanx completely repeated; V-type, first A metacarpal bifurcation and a proximal phalanx base of the repeated fingers form a joint respectively; a type VI, a metacarpal repeat, and a complete thumb repeat; a type VII, a normal thumb is a three-section phalanx or a partial three-section phalanx finger.

4. Bow-shaped finger: Bow-shaped finger: the bow is bowed to the palm 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 has been reported in many areas from northeast to southwest. It mainly occurs in the provinces of Hei, Ji, Liao, Shaanxi and Jin, and is mostly distributed in mountainous areas. And in the mid-levels, 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. The malformation can be one of the signs of certain syndromes, with more than 30 syndromes and more with such malformations. Often combined with and refers to, short finger deformity and so on.

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