7. Hand and Wrist MCQs

A 45-year-old female with a history of scaly plaques on her extensor surfaces presents with chronic hand pain. Radiographs demonstrate erosive changes at the distal interphalangeal (DIP) joints, characterized by proximal phalanx tapering and distal phalanx base expansion. Which of the following is the most likely diagnosis?

A child with Down syndrome presents with a characteristic hand anomaly.

What is the specific anatomic basis of the clinodactyly commonly observed in these patients?

A 45-year-old female with a history of scaly plaques on her extensor surfaces and nail pitting presents with hand pain. Radiographs demonstrate a "pencil-in-cup" deformity of the distal interphalangeal joints. Which of the following is the most likely diagnosis?

A 45-year-old male presents with worsening pain and stiffness in his fingers. Exam shows nail pitting and dactylitis. Radiographs reveal osteolysis of the proximal phalanx with bony proliferation of the distal phalanx base. What is the most likely diagnosis?

Which radiographic feature in the hand is characteristic of psoriatic arthritis and helps distinguish it from rheumatoid arthritis?

Which of the following physical examination findings in the hand is highly characteristic of psoriatic arthritis but is exceptionally rare in rheumatoid arthritis?

A hand surgeon is contemplating soft tissue release for severe joint contractures in a patient with diffuse cutaneous systemic sclerosis (scleroderma). What is the most critical perioperative complication the surgeon must anticipate?

A 50-year-old female with limited cutaneous systemic sclerosis (CREST syndrome) complains of hand stiffness and Raynaud's phenomenon. Which of the following autoantibodies is most highly associated with this patient's specific subtype of scleroderma?

A patient with diffuse systemic sclerosis (scleroderma) requires a reconstructive hand procedure. This patient is known to be at high risk for progressive interstitial lung disease. Which of the following autoantibodies is most highly associated with the diffuse form of this disease and pulmonary fibrosis?

A 45-year-old female with systemic sclerosis (scleroderma) suffers from severe, medically refractory Raynaud's phenomenon. She is scheduled for a digital sympathectomy. Which of the following is the primary anatomic target during this procedure?

Which of the following joint deformities is classically associated with the natural progression of untreated polyarticular Juvenile Idiopathic Arthritis in the hand and wrist?

Dysplasia Epiphysealis Hemimelica (DEH) predominantly affects the lower extremities. Which of the following groups of bones represents the most common sites of involvement?

A resident is evaluating a 7-year-old male with suspected Dysplasia Epiphysealis Hemimelica (DEH). Which of the following anatomical locations is considered extremely rare for this pathology?

According to the Azouz classification for Dysplasia Epiphysealis Hemimelica, which of the following accurately describes the 'classic' form of the disease?

While Dysplasia Epiphysealis Hemimelica primarily affects long bone epiphyses, it can occasionally present in the wrist or foot. Why are the carpal and tarsal bones susceptible to this condition?

A 35-year-old man presents with progressive weakness and painless burns on his hands. Neurological examination reveals loss of pain and temperature sensation in a cape-like distribution over his shoulders and upper extremities, with preserved light touch. MRI is shown.

What is the most common associated condition?

A 42-year-old male undergoes a two-incision (Boyd-Anderson) surgical repair of a chronic distal biceps tendon rupture. Postoperatively, he demonstrates an inability to actively extend his thumb and fingers at the metacarpophalangeal (MCP) joints. However, his wrist extension is preserved, though it deviates radially. Which nerve was most likely injured during the surgical exposure?

A 50-year-old male is diagnosed with cubital tunnel syndrome. During surgical decompression, the surgeon must release the ulnar nerve through several potential sites of compression. Which of the following structures is the MOST common site of ulnar nerve compression in the cubital tunnel?

A 50-year-old carpenter presents with numbness in his small and ring fingers and intrinsic muscle weakness. He is diagnosed with cubital tunnel syndrome. During surgical decompression, the ulnar nerve is found to be compressed as it passes between the humeral and ulnar heads of the flexor carpi ulnaris (FCU). What is the eponymous name of the fascial band connecting these two heads?