They reported that a proximal interphalangeal (PIP) flexion angle of approximately 50[degrees] and distal interphalangeal (DIP) flexion angle of approximately 25[degrees] caused the least amount of force on the tendons and joints of the hand.
[FIGURE 1 OMITTED] [FIGURE 2 OMITTED] [FIGURE 3 OMITTED] [FIGURE 4 OMITTED] [FIGURE 5 OMITTED] [FIGURE 6 OMITTED] It is also necessary to check for swelling / agglutination of the distal interphalangeal joints (Heberden arthrosis) and swelling / agglutination of the proximal interphalangeal joints (Bouchard arthrosis).
Clubbing Clubbing of the distal fingers is identified by the following three criteria: (1) flattening of the angle formed by the junction of the proximal nail plate and the paronychial fold, (2) rounding of the nail plate such that the distal edge curves slightly around the distal tip of the digit, and (3) widening or thickening of the digit from the distal interphalangeal joint to the tip.
Osteoarthritis affects the proximal interphalangeal row and the distal interphalangeal row (last row of finger joints- the ones farthest away from the wrist).
[FIGURE 7 OMITTED] [FIGURE 8 OMITTED] DIAGNOSIS Gout of the hand and wrist, with carpal tunnel syndrome DISCUSSION The typical upper-extremity lesions of gout are tophi within the subcutaneous tissues, more commonly around the extensor surface of the elbow joint1 and PIP joints of the hand, followed, in order, by the MCP and distal interphalangeal joints.