Inspection
The following features of the hand should be noted:
- the posture of the hand
- swellings:
- rheumatoid nodules
- Heberden's and Bouchard's nodes in osteoarthritis
- ganglions
- enchondroma
- tophi
- nail signs e.g. the pitting of psoriasis
- scars
- colour of the hands
- deformity:
- mallet finger
- Swan-neck deformity
- Boutonniere deformity
- Volkmann's contracture
- ulnar deviation
- if there is joint disease note the distribution and whether it is symmetrical
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