From the Guidelines
The limited range of motion in the left hand, particularly in the little finger with 0 degrees of flexion, suggests a significant underlying condition that requires prompt evaluation and treatment to prevent long-term morbidity and mortality, and to improve quality of life. The measurements provided for the left hand indicate the range of motion in degrees for the metacarpophalangeal joints (MCPJ) of different fingers. The index finger (IF) has 45 degrees of flexion, middle finger (MF) has 70-85 degrees, ring finger (RF) has 90 degrees, and little finger (LF) has 0 degrees. These findings suggest significant limitation in the little finger's MCPJ movement, which could indicate joint stiffness, contracture, or injury. Normal MCPJ flexion typically ranges from 85-100 degrees, so the index finger also shows moderate restriction. The middle finger has mild to moderate limitation, while the ring finger demonstrates near-normal flexion. This pattern of varying joint mobility could result from conditions like osteoarthritis, rheumatoid arthritis, post-traumatic stiffness, Dupuytren's contracture, or tendon injuries.
According to the American College of Radiology Appropriateness Criteria 1, radiographs of the area of interest are usually appropriate for the initial imaging of adults with acute blunt or penetrating trauma to the hand or wrist. Given the significant limitation in the little finger's MCPJ movement, initial radiographs of the hand, including the MCPJ, are recommended to evaluate for potential fractures or dislocations. If the initial radiographs are negative or equivocal, repeat radiographs in 10-14 days, MRI without IV contrast, or CT without IV contrast may be considered as the next imaging study 1.
Treatment would depend on the underlying cause but might include physical therapy, splinting, anti-inflammatory medications, or in severe cases, surgical intervention. A complete hand evaluation including other joints (PIP, DIP) and grip strength would be necessary for comprehensive assessment and treatment planning. The use of CT or MRI for further evaluation should be guided by the clinical suspicion of specific conditions, such as fractures, ligamentous injuries, or tendon injuries, as recommended by the American College of Radiology Appropriateness Criteria 1.
From the Research
Left Hand Movement
- The given information about the left hand is: MCPJ IF 45 MF 70-85 RF 90 LF 0.
- This appears to be a description of the range of motion in the left hand, specifically at the metacarpophalangeal joint (MCPJ) and other joints.
- However, there is no direct information in the provided studies that relates to this specific description of hand movement.
Relevant Studies
- The provided studies focus on pain management after hand surgery, carpal tunnel syndrome, and physical examination of the hand 2, 3, 4, 5, 6.
- None of these studies directly address the range of motion in the hand or provide information on what the given values (MCPJ IF 45 MF 70-85 RF 90 LF 0) represent in a clinical context.
Hand Examination and Surgery
- A study on the physical examination of the hand provides a systematic process for performing a comprehensive examination, including vascular, sensory, and motor assessments 2.
- Other studies compare the efficacy of different pain management regimens after hand surgery, including opioid and non-opioid analgesics 3, 5, 6.
- A systematic review on carpal tunnel syndrome discusses the effectiveness of surgical and postsurgical interventions, including manual therapy and corticosteroid injections 4.