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Joints of the hand, X-ray Interphalangeal ligaments and phalanges. Right hand. Deep dissection. Posterior (dorsal) view. The PIP joint exhibits great lateral stability. Its transverse diameter is greater than its antero-posterior diameter and its thick collateral ligaments are tight in all positions during flexion, contrary to those in the metacarpophalangeal joint.
They are seen in osteoarthritis, where they are caused by the formation of calcific spurs of the articular (joint) cartilage. Much less commonly, they may be seen in rheumatoid arthritis, where nodes are caused by antibody deposition to the synovium. A Bouchard's node on the proximal interphalangeal joint of the index finger of a 64 year old man.
The next joint, moving closer to the hand, is the proximal interphalangeal (PIP) joint. The thumb differs by only having two bones and one interphalangeal joint. [10] The injured finger may be examined to determine where the pain is worst. [3] If the finger is sprained or dislocated, pain will be worse at the joint rather than the bone. [3]
The carpometacarpal joint connects the carpal bones to the metacarpus or metacarpal bones which are joined at the intermetacarpal articulations. In the fingers, finally, are the metacarpophalangeal joints (including the knuckles) between the metacarpal bones and the phalanges or finger bones which are interconnected by the interphalangeal joints
A hand imitating an ulnar claw. The metacarpophalangeal joints of the 4th and 5th fingers are extended and the Interphalangeal joints of the same fingers are flexed.. An ulnar claw, also known as claw hand or Spinster’s Claw, is a deformity or an abnormal attitude of the hand that develops due to ulnar nerve damage causing paralysis of the lumbricals.
This initial inflammation and pain eventually subsides, and the patient is left with a permanent bony outgrowth that often skews the fingertip sideways. Bouchard's nodes may also be present; these are similar bony growths in the proximal interphalangeal (PIP) joints (middle joints of the fingers), and are also associated with osteoarthritis.
In some trigger finger patients, tenderness is found in the dorsal proximal interphalangeal (PIP) joint. Dorsal PIP joint tenderness is more common in trigger fingers than previously thought. It is also associated with higher and prolonged levels of postoperative pain after A1 pulley release.
In smaller joints, such as at the fingers, hard bony enlargements, called Heberden's nodes (on the distal interphalangeal joints) or Bouchard's nodes (on the proximal interphalangeal joints), may form, and though they are not necessarily painful, they do limit the movement of the fingers significantly.