Hand & Wrist Examination (Combined Summary)

Erythema, scleroderma, atrophy, scars, rashes, swelling and its distribution, muscle wasting

Ulnar deviation, volar subluxation, swelling

Swelling, deformities (swan necking, boutonniere, Z deformity of thumb in RA), Heberden's nodes (OA), Bouchard's nodes (OA), dactylitis (Psoriatic Arthritis)

Psoriatic nails (hyperkeratosis, onycholysis, pitting, ridging, discoloration)

Erythema, thenar and hypothenar wasting, Dupuytren's contracture

Check for synovitis, effusions, ROM, crepitus, subluxation

Perform if active flexion reduced in one or more fingers

e.g., buttoning up a shirt, writing with a pen

Check for subcutaneous nodules, psoriatic rashes