II. Findings: Degenerative Arthritis (Osteoarthritis)

  1. Heberden's Nodes involve DIP Joints
  2. Bouchard's Nodes involve PIP Joints
  3. First carpal-Metacarpal joint involvement (thumb)
  4. Secondary degenerative Arthritis
    1. Hemochromatosis: involves second and third MCP joints
    2. Superimposed Gouty Arthritis of PIP and DIP joints

III. Findings: Rheumatoid Arthritis

  1. Symmetrical swelling PIP, MCP and wrist
  2. DIP joint involvement is rare in Rheumatoid Arthritis
  3. Extensor tenosynovitis or rupture may occur

IV. Findings: Psoriasis

  1. Involves any hand joint (especially DIP joints)
  2. Sausage-like swelling of digits
  3. Classic psoriatic Plaque and Nail Pitting (60-80%)

V. Findings: Gout

  1. Tophi may be present
  2. Monoarticular Arthritis most common

VI. Findings: Pseudogout

  1. Wrists characteristically involved
  2. Older patients with acute Wrist Pain and swelling
  3. Other hand joints rarely involved

VII. Findings: Gonococcal Arthritis

  1. Common onset in young women at start of Menses
  2. Wrist tenosynovitis may occur
  3. Classic vesicular rash seen in Gonorrhea

VIII. Findings: Systemic Sclerosis and Scleroderma

  1. Fingertip atrophy
  2. Calcific Nodules
  3. Digital Cyanosis
  4. Sclerodactyly: tightening of skin around digits

IX. Findings: Dupuytren's Contracture (Palmar Fibromatosis)

  1. Grade 1: Thickened Nodule/band in palmar aponeurosis
  2. Grade 2: Peritendinous band; limited finger extension
  3. Grade 3: Flexion contracture of finger

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