Diagnosing Hand Conditions

How are hand conditions diagnosed?

Diagnosing many hand conditions may require surgery, depending on the underlying cause of the condition. In general, diagnostic procedures for hand conditions may include the following:

• Complete history and physical examination Your physician will need to know your age, hand preference, occupation, and any history of other problems with the affected extremity. For injuries, your physician may also need to know the following:

  • Type of trauma that occurred

  • When and where the trauma occurred

  • Other circumstances about the trauma (i.e., was it work-related, with a contaminated piece of machinery or chemical)

  • Position of the thumb during the injury or fall

• Your past medical history (including tetanus immunization status and current medications)

In some cases, a diagnosis can be made simply based on a physical examination. However, the following tests may also be used to help confirm the diagnosis, or the extent of the problem:

• Arthrography - a contrast dye is injected into the hand to allow for better visualization of the joints on x-ray.

• Bone scintigraphy - a dye is injected into a vein and images are obtained to show the distribution of activity of the dye in various tissues and structures. The study is usually conducted in phases, with images of the hand taken at different times after the injection of the dye.

• Computed tomography scan (also called a CT or CAT scan) - a diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce horizontal, or axial, images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general x-rays.

• Electromyogram (EMG) - a test that measures the electrical activity of a muscle or a group of muscles. An EMG can detect abnormal electrical muscle activity due to diseases and neuromuscular conditions.

• Magnetic resonance imaging (MRI) - a diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body; allows for visualization of the tendons, ligaments, vessels, and nerves in the hand.

• Ultrasound (also called sonography) - a diagnostic imaging technique which uses high-frequency sound waves and a computer to create images of blood vessels, tissues, and organs. Ultrasounds are used to view internal organs as they function, and to assess blood flow through various vessels. In the hand, ultrasound is useful for locating fluid collections, such as cysts.

• Video fluoroscopy - a diagnostic test that allows visual examination of the movement of the hand that can be recorded on a video for repeated viewing. A fluoroscope is a device that takes an x-ray and allows for immediate projection of the image on a screen for examination.

• X-ray - a diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.