Pain or Limitation of Hand Movements

CLINICAL DIAGNOSTIC MANUAL

Pain or limitation of hand movements are common issues that can affect patients’ functionality and quality of life. These symptoms can be caused by a variety of conditions affecting the bones, joints, tendons, and nerves of the hand. A detailed evaluation of the symptoms, along with complementary tests, is essential to identify the underlying cause and provide appropriate treatment.

Condition	Symptoms and Clinical Signs	Suspected Diagnosis	Confirmatory Diagnosis
Carpal Tunnel Syndrome	Pain and paraesthesia in the hand, weakness in grip	History of characteristic symptoms, positive Tinel and Phalen tests	EMG and nerve conduction studies
Dupuytren’s Disease	Thickening and contracture of the palmar fascia, nodules in the palm	History of progressive contracture and presence of nodules in the palm	Clinical evaluation, ultrasound
Ganglion Cyst	Palpable mass on the wrist, occasionally painful	History of a fluctuating mass on the dorsum of the wrist	Ultrasound or MRI
Rheumatoid Arthritis	Pain, swelling, and morning stiffness in the small joints of the hands	History of joint pain and stiffness, rheumatoid nodules	Positive RF and anti-CCP, X-rays showing joint erosions
Psoriasis	Joint pain and inflammation, psoriatic skin plaques, dactylitis	History of cutaneous psoriasis, articular symptoms	Clinical evaluation, skin biopsy if necessary
Trigger Finger	Pain and locking on finger flexion, “snapping” sensation	History of locking and pain in the affected finger	Clinical evaluation, ultrasound if necessary
De Quervain’s Syndrome	Pain on the radial side of the wrist, especially with thumb movement	History of pain at the base of the thumb, positive Finkelstein test	Clinical evaluation, ultrasound if necessary
Volkmann’s Ischaemic Contracture	Pain, stiffness, and deformity of the hand and fingers, usually after severe injury	History of severe traumatic injury	Clinical and radiographic evaluation
Soft Tissue Injury	Pain, swelling, bruising, and movement limitation depending on injury severity	History of trauma or repetitive strain	Clinical evaluation, ultrasound or MRI for severe injuries
Fracture	Acute pain, visible deformity, swelling, inability to move the hand or fingers	History of trauma, intense pain, and deformity	Hand X-ray