A Hole In One

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A Hole In One - Page #1

Author: Rock Vomer, DO, DPT Co Author #1: Andre Abadin, DO Co Author #2: George G.A. Pujalte, MD, FACSM, FAMSSM Senior Editor: Marc Hilgers, MD, PhD, FAMSSM Editor: Blake Corcoran, MD, CAQSM Patient Presentation: A 62-year-old, right-handed male presented after a two month history of right index finger pain. History: A 62-year-old, right-handed male presented after a two month history of right index finger pain. Pain was localized to the distal aspect of his palm. He noted a locking sensation in his finger. He worked as a statistician and typed every day. He had no treatments prior to presentation. No ergonomic assessments or adjustments were made prior to presentation. He had no prior hand injuries or operations. He had no history of this type of pain. He golfed three times per week and was an avid runner and biker. He had no contributing medical or family history. Physical Exam: Right wrist and hand: No deformity, ecchymosis, or swelling. Tenderness to palpation of the base of the second metacarpal-phalangeal joint. Palpable nodule located near the A1 pulley of the second finger. No triggering elicited with passive motion of the finger. Full active range of motion with finger flexion, abduction, abduction, and opposition. Active range of motion was limited with terminal second digit extension, right wrist flexion, and abduction. Normal dermatomal and myotomal testing of C5-C8 and T1. Malalignment characterized by abduction of the ulna, flexion of the radiocarpal joint, and posterior subluxation of the second metacarpal. Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.		Back
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