Mão- Patologia

Patologia das mãos e dedos

Acroesteolis

http://boneandspine.com/acro-osteolysis/

https://radiopaedia.org/articles/acro-osteolysis-1

http://www.rightdiagnosis.com/medical/acroosteolysis.htm

https://synapse.koreamed.org/Synapse/Data/PDFData/1010JRD/jrd-23-193.pdf

https://www.researchgate.net/publication/269466519_Hajdu-Cheney_syndrome_a_review

Dedo em martelo (mallet finger, dropped finger, baseball finger)

·         Deve-se à lesão dos tendões dos extensores

·         A ponta do dedo cai sem haver flexão muscular.

·         O dedo cai e não se endireita

http://www.eatonhand.com/hw/hw015.htm

Acontece quando  é aplicada uma força súbita na ponta dedo, por exemplo ao fazer a cama, provocando o estiramento ou ruptura do tendão que poderá levar a arrancar fragmentos de osso

 

Aplicaçao de uma força subita

Arrancamento do tendão

Arrancamento do osso

http://orthoinfo.aaos.org/topic.cfm?topic=a00018

http://emedicine.medscape.com/article/1242305-treatment

http://www.emedicinehealth.com/mallet_finger/article_em.htm

https://en.wikipedia.org/wiki/Mallet_finger

https://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000538.htm

http://www.webmd.com/fitness-exercise/mallet-finger

http://radiopaedia.org/articles/mallet-finger

http://www.medicalnewstoday.com/articles/315600.php?utm_source=newsletter

Escafoide

http://boneandspine.com/scaphoid-bone-anatomy/

Fractura do escafoide

É frequente nas quedas com a mão estendida

http://www.joint-pain-expert.net/scaphoid-fracture.html

http://www.assh.org/handcare/hand-arm-injuries/scaphoid-fracture

http://patient.info/forums/discuss/browse/accidents-and-injuries-3470

http://emedicine.medscape.com/article/397230-overview

http://radiopaedia.org/articles/scaphoid-fracture~

http://www.aafp.org/afp/2004/0901/p879.html

https://en.wikipedia.org/wiki/Scaphoid_fracture

http://www.foundrysportsmedicine.com/popular/2015/6/17/you-call-it-a-wrist-fracture-we-call-it-a-scaphoid-fracture

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3051891/

Fracturas do radio  distal ( fracturas do punho)

http://orthoinfo.aaos.org/topic.cfm?topic=A00412

http://emedicine.medscape.com/article/1245884-treatment

https://en.wikipedia.org/wiki/Distal_radius_fracture

http://radiopaedia.org/articles/distal-radial-fractures

http://www.orthobullets.com/trauma/1027/distal-radius-fractures

https://www2.aofoundation.org/wps/portal/surgery?showPage=diagnosis&bone=Radius&segment=Distal

http://www.assh.org/handcare/hand-arm-injuries/wrist-fractures

https://www.hss.edu/conditions_distal-radius-fractures-of-the-wrist.asp

http://www.boneandjoint.org.uk/content/focus/distal-radius-fracture-current-concepts-and-management

Polegar do esquiador

Deve-se à lesão do ligamento cubital colateral que pode chegar a arrancar um fragmento de osso

http://www.emedicinehealth.com/skiers_thumb/article_em.htm

http://emedicine.medscape.com/article/98460-treatment

https://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000572.htm

http://www.webmd.com/a-to-z-guides/skiers-thumb?print=true

http://www.drugs.com/cg/skier-s-thumb.html

Polegar do guarda redes

http://emedicine.medscape.com/article/97679-overview

https://en.wikipedia.org/wiki/Gamekeeper%27s_thumb

http://radiopaedia.org/articles/gamekeeper-thumb

http://orthopedics.about.com/cs/handcondiitions/a/gamekeepers.htm

http://www.rushortho.com/skiers-gamekeepers-thumb.cfm

Dupuytren

É uma contractura provocada pelo espessamento da aponevrose que cobre a palma da mão.

Começa por pequenos nódulos nas palmas das mãos. Nalguns doentes formam-se cordões que obrigam à flexão dos dedos para a palma da mão,impedindo que se estendam para voltarem à posição original

A sua causa é desconhecida.

http://www.eatonhand.com/hw/hw009.htm

http://www.dupuytren-online.info/

https://en.wikipedia.org/wiki/Dupuytren%27s_contracture

http://www.mayoclinic.org/diseases-conditions/dupuytrens-contracture/basics/definition/con-20024378

http://emedicine.medscape.com/article/329414-overview

http://www.medicinenet.com/dupuytren_contracture/article.htm

http://www.nhs.uk/conditions/Dupuytrens-contracture/Pages/Introduction.aspx

http://www.assh.org/handcare/hand-arm-conditions/dupuytrens-contracture

http://www.webmd.com/a-to-z-guides/features/dupuytrens-contracture-causes

https://www.nlm.nih.gov/medlineplus/ency/article/001233.htm

http://www.physio-pedia.com/Dupuytren%E2%80%99s_Contracture

http://www.advantagephysiotherapy.com/Injuries-Conditions/Hand/Hand-Issues/Dupuytrens-Contracture-Patient-Guide/a~4516/article.html

http://www.enbuenasmanos.com/articulos/muestra.asp?art=3655

Artrite das mãos

As mais frequentes são as da base do polegar  e as interfalangicas proximais e distais

Também se observam no punho

Podem-se desenvolver nódulos ósseos, os nodulos de Heberden e de Bouchard

Nodulos de Heberden

https://en.wikipedia.org/wiki/File:Heberden-Arthrose.JPG

http://www.healthline.com/health/osteoarthritis/heberdens-nodes

http://www.webmd.com/arthritis/heberdens-and-bouchards-nodes

http://osteoarthritis.about.com/od/handosteoarthritis/a/Heberdens_nodes.htm

http://www.turner-white.com/pdf/hp_jul01_nodes.pdf

http://ard.bmj.com/content/58/11/675.full

http://www.miamihandcenter.com/hand/osteoarthritis

Artrite do polegar

A mais frequente é a artrite da articulação trapeziometacarpica do polegar que articula o trapézio com o 1º metacarpo

É mais frequente nas mulheres com mais de 40 anos.

Manifesta-se por uma dor profunda na base do polegar, podendo ser afectados os movimentos de oposição e preensão

Em casos graves o polegar colapsa para a palma da mão, criando uma deformidade em zigue-zague

As artrites das outras articulações metacarpo-falangicas são mais raras

http://www.mayoclinic.org/diseases-conditions/thumb-arthritis/basics/definition/con-20027798

http://orthoinfo.aaos.org/topic.cfm?topic=A00210

http://www.healthline.com/health/osteoarthritis/thumb#Causes3

http://www.mayoclinic.org/diseases-conditions/thumb-arthritis/basics/definition/con-20027798

http://www.arthritis.org/living-with-arthritis/treatments/joint-surgery/types/other/new-thumb-surgery-options.php

http://www.mayoclinic.org/diseases-conditions/thumb-arthritis/basics/treatment/con-20027798

http://www.assh.org/handcare/hand-arm-conditions/arthritis-base-of-thumb

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2599975/

http://www.orthop.washington.edu/?q=patient-care/hand/thumb-arthritis.html

Artrite reumatóide da mão

Podem ser atingidas todas as articulações da mão

É uma doença sistémica altamente incapacitante

http://arthritis.about.com/od/arthqa/f/ulnardeviation.htm

http://emedicine.medscape.com/article/401271-overview

Soft-tissue swelling and early erosions in the proximal interphalangeal joints in a patient with rheumatoid arthritis of the hands.

http://www.webmd.com/rheumatoid-arthritis/guide/hand-and-finger-ra

http://www.webmd.com/rheumatoid-arthritis/features/hand-exercises-rheumatoid-arthritis

http://www.assh.org/handcare/hand-arm-conditions/Rheumatoid-Arthritis

http://www.mayoclinic.org/diseases-conditions/rheumatoid-arthritis/symptoms-causes/dxc-20197390

Dedo em gatilho

É a tenosinovite estenosante.

Os tendões dos músculos da mão ao entrarem na mão passam por uma série de anais, as polias, que orientam o tendão como as guias de uma cana de pesca

Quando se forma um edema ou surge um nódulo o escorregamento do tendão é dificultado ou impedido o que leva à contracção do dedo, que muitas vezes fica bloqueado.

http://orthoinfo.aaos.org/tpic.cfm?topic=A00024

The thickened nodule on the flexor tendon strikes the sheath tunnel, making it difficult to straighten the finger.

Reproduced and adapted from Griffin LY (ed): Essentials of Musculoskeletal Care. 3rd Ed. Rosemont, IL. American Academy of Orthopaedic Surgeons, 2005

Top of page

http://www.mayoclinic.org/diseases-conditions/trigger-finger/basics/definition/con-20043819

http://www.assh.org/handcare/hand-arm-conditions/trigger-finger

http://www.webmd.com/osteoarthritis/guide/trigger-finger

http://emedicine.medscape.com/article/1244693-overview

https://en.wikipedia.org/wiki/Trigger_finger

http://www.medicinenet.com/trigger_finger/article.htm

http://www.nhs.uk/conditions/trigger-finger/Pages/Introduction.aspx

http://www.eatonhand.com/hw/hw022.htm

Tendonite de de Quervain

É a inflamação dos tendões do polegar na base do punho.Manifesta-se por dores no punho

http://www.mayoclinic.org/diseases-conditions/de-quervains-tenosynovitis/basics/definition/con-20027238

http://emedicine.medscape.com/article/1243387-overview

http://orthoinfo.aaos.org/topic.cfm?topic=a00007

https://en.wikipedia.org/wiki/De_Quervain_syndrome

http://www.medicinenet.com/de_quervains_tenosynovitis/article.htm

http://www.assh.org/handcare/hand-arm-conditions/de-quervain-syndrome

https://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000537.htm

Quistos ganglionares

São pequenas tumefacções que aparecem nas mãos e nos punhos

https://en.wikipedia.org/wiki/File:Cyst_Profile2.JPG

http://www.joint-pain-expert.net/ganglion.html

http://www.eatonhand.com/hw/hw013.htm

http://emedicine.medscape.com/article/1243454-overview

http://orthoinfo.aaos.org/topic.cfm?topic=A00006

http://www.emedicinehealth.com/ganglion_cyst/article_em.htm

http://www.assh.org/handcare/hand-arm-conditions/ganglion-c

http://www.mayoclinic.org/diseases-conditions/ganglion-cyst/home/ovc-20168586

Fractura de Bennett

Fractura associada a luxação do lº metacárpico

Dá uma grande instabilidade na articulação

Ocorre no futebol

http://www.joint-pain-expert.net/bennett-fracture.html

You can not do this movement if you have Bennett Fract

https://en.wikipedia.org/wiki/Bennett%27s_fracture

http://radiopaedia.org/articles/bennett-fracture-dislocation

http://emedicine.medscape.com/article/1238036-overview

http://www.wheelessonline.com/ortho/bennetts_fracture_dislocation

http://patient.info/doctor/bennetts-fracture-and-other-thumb-injurie

http://www.orthobullets.com/hand/6036/base-of-thumb-fractures

  

Fractura do boxeur

https://en.wikipedia.org/wiki/Boxer%27s_fracture

Boxer's Fracture is a colloquial term for a fracture of one of the metacarpal bones of the hand. Classically, the fracture occurs transversely across the neck of the bone, after the patient strikes an object with a closed fist. 

https://www.info-radiologie.ch/fracture-boxeur.php

http://www.emedicinehealth.com/boxers_fracture/article_em.htm

http://www.webmd.com/a-to-z-guides/boxers-fracture?print=true

http://radiopaedia.org/articles/boxer-fracture-1

http://www.medicalnewstoday.com/articles/319297.php?utm_source=newsletter&utm_medium=email&utm_campaign=weekly-hcp

http://www.eatonhand.com/hw/hw005.htm

Fracturas dos dedos

http://www.eatonhand.com/hw/hw010.htm

http://orthoinfo.aaos.org/topic.cfm?topic=a00257

http://www.emedicinehealth.com/broken_finger/article_em.htm

http://www.healthline.com/health/broken-finger

http://www.aafp.org/afp/2012/0415/p805.html

http://emedicine.medscape.com/article/98322-treatment

http://www.nhs.uk/conditions/broken-finger/Pages/Introduction.aspx

http://www.webmd.boots.com/fitness-exercise/guide/broken-finger

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2684218/

Instabilidade do pulso

http://boneandspine.com/wrist-instability/

https://emedicine.medscape.com/article/1241610-overview

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3633542/

http://www.radiologyassistant.nl/en/p42a29ec06b9e8/wrist-carpal-instability.html

https://emedicine.medscape.com/article/1241610-treatment

https://www.physio-pedia.com/Lunate_Instability

http://meddb.eznetpublish.ihealthspot.com/tabid/9153/mid/14786/ContentPubID/80/ContentClassificationGroupID/-1/Default.aspx

http://sportho.net/Anatomical/UpperLimb/wrist/Wrist_Ligaments_and_Instability.pdf

https://www.orthoillustrated.com/wrist/instability