Trigger finger (stenosing flexor tenosynovitis)

Dupuytren contracture is fibroblastic proliferation and collagen deposition in the palmar fascia that produces painless nodules, then palmar cords, then a fixed flexion contracture of the ring and little fingers, typically after the fifth decade in White men. It is a clinical diagnosis on palpation and inspection, treated with intralesional collagenase or surgical fasciectomy once a joint contracture limits extension.

De Quervain tendinopathy is noninflammatory thickening of the abductor pollicis longus and extensor pollicis brevis tendons at the first dorsal wrist compartment, diagnosed clinically by radial wrist pain reproduced on the Finkelstein test. First-line care is rest, NSAIDs, and thumb spica splinting, escalating to corticosteroid injection and then surgical release for refractory cases.

A ganglion cyst is a mucin-filled swelling that herniates from a joint capsule or tendon sheath, most often on the dorsal wrist, diagnosed clinically by transillumination and managed with observation, aspiration with corticosteroid injection, or surgical excision for persistent or symptomatic cysts.

Hand infections range from paronychia and purulent abscess to limb-threatening necrotizing fasciitis, are diagnosed by anatomic pattern and bite or wound history, and are managed by prompt incision and drainage or debridement plus empiric antibiotics targeting staphylococci, streptococci, and bite-specific organisms.

Rheumatoid arthritis is a chronic systemic autoimmune disease causing symmetric small-joint polyarthritis of the hands and feet that spares the distal interphalangeal joints, with morning stiffness over an hour. Diagnosis combines the ACR/EULAR classification criteria with rheumatoid factor, anti-CCP antibody, and radiographs. Treat-to-target management anchors on methotrexate, escalating to a biologic or targeted synthetic disease-modifying antirheumatic drug when remission is not reached.

Carpal tunnel syndrome is compression of the median nerve at the wrist causing pain, paresthesia, and eventually weakness in the thumb, index, middle, and radial half of the ring finger, treated first with neutral wrist splinting and, when refractory, with corticosteroid injection or surgical decompression.

Ulnar neuropathy is compression of the ulnar nerve (C8-T1), most often at the elbow in the cubital tunnel and less often at the wrist in Guyon canal, causing numbness of the fourth and fifth fingers and, when severe, intrinsic hand weakness, hypothenar atrophy, and an ulnar claw. Diagnosis is clinical with nerve conduction studies and EMG for confirmation, and treatment is avoidance of pressure, splinting, and short-term NSAIDs, with surgical decompression for progressive weakness or persistent symptoms.

Type 2 diabetes is hyperglycemia from insulin resistance with progressive relative insulin deficiency, diagnosed by a hemoglobin A1c of 6.5% or higher, a fasting glucose of 126 mg/dL or higher, or a 2-hour oral glucose tolerance test value of 200 mg/dL or higher. First-line treatment is lifestyle modification plus metformin, with an SGLT2 inhibitor or GLP-1 receptor agonist added early for patients with atherosclerotic disease, kidney disease, or heart failure.