PT EVALUATION:

METABOLIC AND ENDOCRINE

CONDITION
BINALA
CAPULE
JALEA
LAUREL
YAP
 SUBJECTIVE DATA

OBJECTIVE DATA

ASSESSMENT DATA
 SUBJECTIVE DATA
• A 58-year old healthy, right-hand dominant
female came to the ER with c/o a 6-week history
of progressive pain in her (L) hand and wrist that
acutely worsened in the past week with the
absence of trauma.
• Patient also reported numbness in the median
nerve distribution, worsening paresthesia in her
thumb , index, long and ring fingers. Radiographs
showed well-corticated ossified densities
overlying the dorsal and volar wrist.
 OBJECTIVE DATA
• The following week patient underwent physical
examination and there was no evidence of atrophic
changes of the abductor pollicis brevis (APB) muscle or
the remainder of the intrinsic hand musculature.
• MRI showed ossified bodies over the dorsal and volar
aspect of the wrist and a partial tear of the flexor
pollicis longus tendon as well as reactive median nerve
neuritis in close proximity to the volar ossified body.
• Aside from the incidental finding of the torn
scapholunate ligament the remainder of the MRI is
unremarkable. Due to the findings, patient was advised
to undergo surgery.
 OBJECTIVE DATA
• There was a palpable, tender protrusion over
the dorsal and volar aspects of the wrist.
• AROM at the wrist was reduced by 25%
relative on the contralateral side.
• MMT grade of the abductor pollicis brevis,
first dorsal interosseous and extensor pollicis
longus were 5/5 and with provocative testing
Tinel’s sign was positive.
 ASSESSMENT DATA
• Postoperatively, patient’s symptoms of pain as
well as numbness and paresthesia in a median
nerve distribution resolved completely.
• . The patient was able to resume her work in
the service industry 4-weeks post-op without
any functional limitations.
 REFERENCE
• Head, L., Bradley, R., & Momtazi, M. (2018).
Tenosynovial chondromatosis of the wrist
presenting with acute carpal tunnel syndrome:
A case report. Hand Surgery and
Rehabilitation,37(2), 117-120.
doi:10.1016/j.hansur.2018.01.001