Ulnar-sided Hand Pain In A Baseball Player

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Ulnar-sided Hand Pain In A Baseball Player - Page #1

Author: Ben Kopecky, DO, MS Co Author #1: Jacob Sellon, MD Senior Editor: Kristine Karlson, MD, FAMSSM Editor: Adam Lewno, DO Patient Presentation: A 23-year-old, right hand dominant, collegiate baseball catcher presented with 2.5 weeks of left hypothenar hand pain. The pain was 4 out of 10 in severity, achy and throbbing at rest, and sharp and stabbing with gripping and batting. It was worsened by gripping and squeezing with the left hand. Since onset, there was minimal relief with ice, Tylenol, and an over-the-counter wrist splint. The patient had no relevant past medical history and no prior injury to the hand or wrist. History: The pain began during a baseball game when he swung hard at a pitch, although he reported feeling a twinge of pain in the same area the week prior during batting practice. At the game, he immediately noticed swelling at the hypothenar eminence, and 4 hours later he felt unable to move his wrist. Physical Exam: Inspection was positive for faint ecchymosis and mild swelling of the left hypothenar region. Palpation demonstrated point tenderness over the hook of the hamate and subcutaneous crepitus over the ulnocarpal joint. Strength testing in the left upper limb was decreased in index finger abduction (3/5) and small finger distal interphalangeal joint flexion (4/5) but was otherwise normal. Sensation and reflexes were normal. Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.		Back
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