ABC of Rheumatology: PAIN IN THE HAND AND WRIST

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Abstract
General considerations Patients presenting with pain in the hand are often anxious. The hands are so important for daily activities and for communication and contact that any actual or perceived threat to their normal function is worrying. For those whose livings are made by intricate use of their hands—musicians, craft workers, keyboard operators—and for heavy labourers, the threat is often greater. More often than not, people can live with their present pain if their fear of future loss of function can be allayed. Causes of pain in hand and wrist At all ages Trauma Flexor tenosynovitis Trigger finger or thumb Carpal tunnel syndrome De Quervain's tenosynovitis Ganglion Dorsal tenosynovitis Inflammatory arthritis Raynaud's syndrome Reflex sympathetic dystrophy Chronic upper limb pain Elderly patients Nodal osteoarthritis: Distal interphalangeal First carpometacarpal Proximal interphalangeal Scaphoid fracture Pseudogout Gout: Acute Chronic tophaceous Dupuytren's contracture Diabetic stiff hand

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