Cheiralgia Paresthetica
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Cheiralgia Paresthetica
Cheiralgia paraesthetica (Wartenberg's syndrome) is a neuropathy of the hand generally caused by compression or trauma to the superficial branch of the radial nerve. The area affected is typically on the back or side of the hand at the base of the thumb, near the anatomical snuffbox, but may extend up the back of the thumb and index finger and across the back of the hand. Symptoms include numbness, tingling, burning or pain. Since the nerve branch is sensory there is no motor impairment. It may be distinguished from de Quervain syndrome because it is not dependent on motion of the hand or fingers. Cause The most common cause is thought to be constriction of the wrist, as with a bracelet or watchband (hence reference to "wristwatch neuropathy"). It is especially associated with the use of handcuffs and is therefore commonly referred to as handcuff neuropathy. Other injuries or surgery in the wrist area can also lead to symptoms, including surgery for other syndromes such as de Querv ...
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Neuropathy
Peripheral neuropathy, often shortened to neuropathy, is a general term describing disease affecting the peripheral nerves, meaning nerves beyond the brain and spinal cord. Damage to peripheral nerves may impair sensation, movement, gland, or organ function depending on which nerves are affected; in other words, neuropathy affecting motor, sensory, or autonomic nerves result in different symptoms. More than one type of nerve may be affected simultaneously. Peripheral neuropathy may be acute (with sudden onset, rapid progress) or chronic (symptoms begin subtly and progress slowly), and may be reversible or permanent. Common causes include systemic diseases (such as diabetes or leprosy), hyperglycemia-induced glycation, vitamin deficiency, medication (e.g., chemotherapy, or commonly prescribed antibiotics including metronidazole and the fluoroquinolone class of antibiotics (such as ciprofloxacin, levofloxacin, moxifloxacin)), traumatic injury, ischemia, radiation therapy, exces ...
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Hand
A hand is a prehensile, multi-fingered appendage located at the end of the forearm or forelimb of primates such as humans, chimpanzees, monkeys, and lemurs. A few other vertebrates such as the koala (which has two opposable thumbs on each "hand" and fingerprints extremely similar to human fingerprints) are often described as having "hands" instead of paws on their front limbs. The raccoon is usually described as having "hands" though opposable thumbs are lacking. Some evolutionary anatomists use the term ''hand'' to refer to the appendage of digits on the forelimb more generally—for example, in the context of whether the three digits of the bird hand involved the same homologous loss of two digits as in the dinosaur hand. The human hand usually has five digits: four fingers plus one thumb; these are often referred to collectively as five fingers, however, whereby the thumb is included as one of the fingers. It has 27 bones, not including the sesamoid bone, the number o ...
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Compression Neuropathy
Nerve compression syndrome, or compression neuropathy, or nerve entrapment syndrome, is a medical condition caused by direct pressure on a nerve. It is known colloquially as a ''trapped nerve'', though this may also refer to nerve root compression (by a herniated disc, for example). Its symptoms include pain, tingling, numbness and muscle weakness. The symptoms affect just one particular part of the body, depending on which nerve is affected. Nerve conduction studies help to confirm the diagnosis. In some cases, surgery may help to relieve the pressure on the nerve but this does not always relieve all the symptoms. Nerve injury by a single episode of physical trauma is in one sense a compression neuropathy but is not usually included under this heading. Syndromes * Upper limb * Lower limb, abdomen and pelvis Signs and symptoms Tingling, numbness, and/or a burning sensation in the area of the body affected by the corresponding nerve. These experiences may occur directl ...
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Physical Trauma
An injury is any physiological damage to living tissue caused by immediate physical stress. An injury can occur intentionally or unintentionally and may be caused by blunt trauma, penetrating trauma, burning, toxic exposure, asphyxiation, or overexertion. Injuries can occur in any part of the body, and different symptoms are associated with different injuries. Treatment of a major injury is typically carried out by a health professional and varies greatly depending on the nature of the injury. Traffic collisions are the most common cause of accidental injury and injury-related death among humans. Injuries are distinct from chronic conditions, psychological trauma, infections, or medical procedures, though injury can be a contributing factor to any of these. Several major health organizations have established systems for the classification and description of human injuries. Occurrence Injuries may be intentional or unintentional. Intentional injuries may be acts o ...
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Radial Nerve
The radial nerve is a nerve in the human body that supplies the posterior portion of the upper limb. It innervates the medial and lateral heads of the triceps brachii muscle of the arm, as well as all 12 muscles in the posterior osteofascial compartment of the forearm and the associated joints and overlying skin. It originates from the brachial plexus, carrying fibers from the ventral roots of spinal nerves C5, C6, C7, C8 & T1. The radial nerve and its branches provide motor innervation to the dorsal arm muscles (the triceps brachii and the anconeus) and the extrinsic extensors of the wrists and hands; it also provides cutaneous sensory innervation to most of the back of the hand, except for the back of the little finger and adjacent half of the ring finger (which are innervated by the ulnar nerve). The radial nerve divides into a deep branch, which becomes the posterior interosseous nerve, and a superficial branch, which goes on to innervate the dorsum (back) of the hand. Th ...
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Anatomical Snuffbox
The anatomical snuff box or snuffbox or foveola radialis is a triangular deepening on the radial, dorsal aspect of the hand—at the level of the carpal bones, specifically, the scaphoid and trapezium bones forming the floor. The name originates from the use of this surface for placing and then sniffing powdered tobacco, or "snuff." It is sometimes referred to by its French name ''tabatière''. Structure Boundaries * The medial border (ulnar side) of the snuffbox is the tendon of the extensor pollicis longus. * The lateral border (radial side) is a pair of parallel and intimate tendons, of the extensor pollicis brevis and the abductor pollicis longus. (Accordingly, the anatomical snuffbox is most visible, having a more pronounced concavity, during thumb extension.) * The proximal border is formed by the styloid process of the radius * The distal border is formed by the approximate apex of the schematic snuffbox isosceles triangle. * The floor of the snuffbox varies depending on ...
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De Quervain Syndrome
De Quervain syndrome is mucoid degeneration of two tendons that control movement of the thumb and their tendon sheath. This results in pain and tenderness on the thumb side of the wrist. Radial abduction of the thumb is painful. On occasion, there is uneven movement or triggering the thumb with radial abduction. Symptoms can come on gradually or be noted suddenly. There is speculation that the problem is related to use of the hand, but this is not supported by experimental evidence. Humans tend to misinterpret painful activities as causing the problem to get worse and this misinterpretation is associated with greater pain intensity. For this reason, it's better not to blame activity without strong scientific support. The diagnosis is generally based on symptoms and physical examination. Diagnosis is supported if pain increases when the wrist is bent inwards while a person is grabbing their thumb within a fist. There is some evidence that the natural history of de Quervain ...
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Handcuffs
Handcuffs are Physical restraint, restraint devices designed to secure an individual's wrists in proximity to each other. They comprise two parts, linked together by a Link chain, chain, a hinge, or rigid bar. Each cuff has a rotating arm which engages with a ratchet (device), ratchet that prevents it from being opened once closed around a person's wrist. Without the key, the handcuffs cannot be removed without specialist knowledge, and the handcuffed person cannot move their wrists more than a few centimetres or inches apart, making many tasks difficult or impossible. Handcuffs are frequently used by law enforcement agencies worldwide to prevent Suspect, suspected criminals from escaping from Arrest, police custody. Styles Metal handcuffs There are three main types of contemporary metal handcuffs: chain (cuffs are held together by a short chain), hinged (since hinged handcuffs permit less movement than a chain cuff, they are generally considered to be more secure), and ri ...
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Etiology
Etiology (pronounced ; alternatively: aetiology or ætiology) is the study of causation or origination. The word is derived from the Greek (''aitiología'') "giving a reason for" (, ''aitía'', "cause"); and ('' -logía''). More completely, etiology is the study of the causes, origins, or reasons behind the way that things are, or the way they function, or it can refer to the causes themselves. The word is commonly used in medicine (pertaining to causes of disease) and in philosophy, but also in physics, psychology, government, geography, spatial analysis, theology, and biology, in reference to the causes or origins of various phenomena. In the past, when many physical phenomena were not well understood or when histories were not recorded, myths often arose to provide etiologies. Thus, an etiological myth, or origin myth, is a myth that has arisen, been told over time or written to explain the origins of various social or natural phenomena. For example, Virgil's ''Aeneid'' is ...
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Edema
Edema, also spelled oedema, and also known as fluid retention, dropsy, hydropsy and swelling, is the build-up of fluid in the body's Tissue (biology), tissue. Most commonly, the legs or arms are affected. Symptoms may include skin which feels tight, the area may feel heavy, and joint stiffness. Other symptoms depend on the underlying cause. Causes may include Chronic venous insufficiency, venous insufficiency, heart failure, kidney problems, hypoalbuminemia, low protein levels, liver problems, deep vein thrombosis, infections, angioedema, certain medications, and lymphedema. It may also occur after prolonged sitting or standing and during menstruation or pregnancy. The condition is more concerning if it starts suddenly, or pain or shortness of breath is present. Treatment depends on the underlying cause. If the underlying mechanism involves Hypernatremia, sodium retention, decreased salt intake and a diuretic may be used. Elevating the legs and support stockings may be useful ...
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NSAID
Non-steroidal anti-inflammatory drugs (NSAID) are members of a therapeutic drug class which reduces pain, decreases inflammation, decreases fever, and prevents blood clots. Side effects depend on the specific drug, its dose and duration of use, but largely include an increased risk of gastrointestinal ulcers and bleeds, heart attack, and kidney disease. The term ''non-steroidal'', common from around 1960, distinguishes these drugs from corticosteroids, which during the 1950s had acquired a bad reputation due to overuse and side-effect problems after their initial introduction in 1948. NSAIDs work by inhibiting the activity of cyclooxygenase enzymes (the COX-1 and COX-2 isoenzymes). In cells, these enzymes are involved in the synthesis of key biological mediators, namely prostaglandins, which are involved in inflammation, and thromboxanes, which are involved in blood clotting. There are two general types of NSAIDs available: non-selective, and COX-2 selective. Mos ...
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Cortisone
Cortisone is a pregnene (21-carbon) steroid hormone. It is a naturally-occurring corticosteroid metabolite that is also used as a pharmaceutical prodrug; it is not synthesized in the adrenal glands. Cortisol is converted by the action of the enzyme corticosteroid 11-beta-dehydrogenase isozyme 2 into the inactive metabolite cortisone, particularly in the kidneys. Cortisone is converted back to the active steroid cortisol by the action of the enzyme 11β-Hydroxysteroid dehydrogenase type 1, particularly in the liver. The term "cortisone" is frequently misused to mean either any corticosteroid or hydrocortisone, which is actually another name for cortisol. Many who speak of receiving a "cortisone shot" or taking "cortisone" are actually receiving hydrocortisone or one of many other, much more potent synthetic corticosteroids; it is unlikely that the drug administered is actually cortisone. Cortisone can be administered as a prodrug, meaning it has to be converted by the body (speci ...
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