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Significance of hand examination in systemic diseases

Examination of hand reveals specific features of systemic diseases.
  • Cold clammy hand with peripheral  cyanosis indicate shock
  • Cold moist hand in anxiety state
  • Cold dry hand is a feature of myxedema
  • Warm moist hand seen in thyrotoxicosis
  • Pallor of palmar crease observed in anemia
  • Wasting and fasciculation of hand muscles- is seen MND, syringomyelia
  • Myotonic disorders can be associated with slow relaxation on shaking hand
  • Cyanosis and clubbing together-Cyanotic CHD, ILD
  • Nail-fold infarct and telangiectasia are seen in vasculitis. SLE, PAN, PSS
  • Osier's node, splinter hemorrhage, Janeway suggestive of infective endocarditis
  • Pigmentation is a feature of Addison's disease, megaloblastic anemia
  • Arachnodactyly is a feature of Marfan's syndrome
  • Deformed hand diagnostic of rheumatoid arthritis 
  • Sclerodactyly in PSS, MCTD
  • Heberden's node are characteristic of osteoarthritis
  • Clawing of hand  in ulnar and median nerve lesion
  • Dupyutren's contracture a feature of alcoholic liver disease, trauma
  • Gottron's papule is seen in dermatomyositis
  • Large spade hand in acromegaly
  • Short 4th metacarpal- pseuda-hypopara thyroidismdism, reverse Marfan's syndrome (Weil-Marchesani syndrome)  and Turner's syndrome
  • Long thumb-fingerization-Holt-Oram syndrome.