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Prayer sign

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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  • diabetic cheiroarthropathy is a term used to describe limited joint mobility in the hand - also termed diabetic hand syndrome, or digital scleroderma
  • characterized by waxy skin-thickening over the dorsum of the hand with restricted mobility, particularly affecting extension of the metacarpophalangeal joints (MCPs), proximal interphalangeal joints (PIPs), and the fifth distal interphalangeal joint (DIP)
  • may exhibit a positive 'prayer sign' , in that the patient will be unable to fully oppose the palmar surfaces of the digits
  • an alternative test for diagnosing diabetic cheiroarthropathy is the 'table top' sign - in this 'test' the patient is unable to place their hand flat on a surface - both the 'prayer sign' and the 'table top' sign are good clinic screening tools, although goniometry remains the gold standard for documenting such restricted joint range
  • other than improvement of diabetic control, there are few therapeutic options for this condition

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