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A patient’s hands are a tremendous source of information and are one of the easiest areas to access and examine. Information about a patient’s circulation, nutrition, muscle mass, frailty, and even the presence of internal illnesses can be gained from examination of the hands. Skin and nail changes, temperature, presence of hair, and many other findings are immediately assessed by experienced clinicians when first meeting a patient. Here are some examples of hand findings that have been featured on Figure 1.

Raynaud’s Phenomenon

Raynaud’s phenomenon is defined by periods of intense vasoconstriction, where blood supply decreases to the fingertips in response to swings in temperature. This phenomenon is classically associated with diseases like lupus and scleroderma, although most patients with this phenomenon do not have either disease.

raynauds

Learn more about this case: Raynaud’s Phenomenon

Polydactyly

Polydactyly is a condition which causes a person to have full or partially formed supernumerary fingers or toes. This condition can be associated with hundreds of conditions, and can also occur sporadically. Functional digits may be retained and patients often have the option of surgery if reduction is necessary or desired.

polydactyly hands

Learn more about this case: Ulnar Polydactyly

Clubbing

Clubbing is a particular type of expansion of the digit tufts which typically co-occurs alongside abnormalities of the heart and lungs, but can be present in other conditions as well, especially ones that affect pulmonary circulation. Clubbed fingers can be recognized by their splayed tip, rounded nails, and soft ballotable nail bed.

clubbing

Learn more about this case: Clubbing from Sickle Cell Anemia


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