Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with progressive deformity of the left hand, characterized by hyperextension of the proximal interphalangeal (PIP) joint and flexion of the distal interphalangeal (DIP) joint. Symptoms include localized stiffness, functional impairment in grip, and discomfort. History is significant for [RA/Connective Tissue Disorder/Trauma].
Clinical Examination Findings
Physical examination of the left hand reveals classic swan neck deformity. PIP joint exhibits fixed or reducible hyperextension with volar plate laxity. DIP joint demonstrates compensatory flexion. Joint stability, range of motion, and neurovascular status are assessed. No signs of acute infection or skin breakdown noted.
Treatment Protocol
Management plan includes conservative measures: custom splinting (e.g., silver ring splints or oval-8) to prevent PIP hyperextension, physical/occupational therapy for range of motion, and NSAIDs/DMARDs for underlying inflammatory control. Surgical consultation for soft tissue reconstruction or arthrodesis if conservative measures fail.