DVBCWHT2 ;ALB/JER HAND, THUMB, FINGERS WKS TEXT ; 31 JULY 2003
;;2.7;AMIE;**58**;JULY 31, 2003
;
TXT ;
;;A. Review of Medical Records:
;;
;;B. Medical History (Subjective Complaints):
;;Are there flair ups of joint disease affecting hand, thumb or fingers?
;; If so:
;; 1. State severity, frequency and duration of flair ups.
;; 2. Name precipitating and alleviating factors.
;; 3. Estimate to what extent, if any, flair ups result in additional
;; limitation of motion or functional impairment.
;;
;;C. Physical Examination (Objective Findings):
;;Designate fingers as: thumb, index, long, ring, and little. Provide a detailed
;;assessment of each affected joint. State whether the individual is right
;;or left hand dominant. Use a goniometer for measuring joint angles. Refer to
;;Residuals of Amputations worksheet, if applicable.
;;
;; 1. Evaluation of Ankylosis
;;For each anklyosed joint, include angle of anklyosis. Describe any rotation or
;;any angulation of bone.
;;Zero degrees of flexion represents the fingers fully extended, making a
;;straight line with the rest of the hand.
;; The "position of function" of the hand is:
;; Wrist dorsiflexion: 20 to 30 degrees
;; Metacarpophalangeal flexion: 30 degrees
;; Proximal interphalangeal joint flexion: 30 degrees
;; Thumb abduction and rotation: thumb pad faces the finger pads.
;;
;; 2. Evaluation of Limitation of Motion of Single or Multiple Digits of the
;; Hand
;;Provide range of motion for each digit of the hand.
;;Normal Ranges of Motion for wrist, index, long, ring and little fingers:
;; Metacarpophalangeal joint (wrist): zero to 90 degrees of flexion
;; Proximal interphalangeal joint: zero to 100 degrees of flexion
;; Distal (terminal) interphalangeal joint: zero to 70 or 80 degrees of flexion
;;
;; 3. Evaluation of Hand as a unit
;;Measure the gap, in inches:
;; Between the tip of the thumb and the fingers
;; Between the tips of the fingers and the proximal transverse crease of the palm
;; Between the thumb pad and the fingers with the thumb attempting to oppose
;; the fingers
;; Describe strength for pushing, pulling and twisting. Describe dexterity for
;; twisting, probing, writing, touching and expression. Comment on whether and
;; how (e.g. decreased range of motion, in degrees) the flexion deformity
;; interferes with the function of the other fingers.
;;
;; 4. Additional detailed measurements and consideration of other factors
;; affecting function
;;Measure the active and passive range of motion of each affected joint. Include
;;movement against gravity and against strong resistance.
;;State whether and to what extent the range of motion (in degrees) or joint
;;function is additionally limited by pain, fatigue, weakness, or lack of
;;endurance following repetitive use or during flair-ups. If more than one
;;of these is present, state, if possible, which has the major functional
;;impact. Include rationale for conclusions.
;;
;; D. Diagnostic and Clinical Tests:
;;Include results of all diagnostic and clinical tests upon which examiner is
;;basing the diagnosis.
;;
;; E. Diagnosis:
;;
;;
;;
;;
;;Signature: Date:
;;END
--- Routine Detail --- with STRUCTURED ROUTINE LISTING ---[H[J[2J[HDVBCWHT2 3435 printed Nov 22, 2024@17:01:59 Page 2
DVBCWHT2 ;ALB/JER HAND, THUMB, FINGERS WKS TEXT ; 31 JULY 2003
+1 ;;2.7;AMIE;**58**;JULY 31, 2003
+2 ;
TXT ;
+1 ;;A. Review of Medical Records:
+2 ;;
+3 ;;B. Medical History (Subjective Complaints):
+4 ;;Are there flair ups of joint disease affecting hand, thumb or fingers?
+5 ;; If so:
+6 ;; 1. State severity, frequency and duration of flair ups.
+7 ;; 2. Name precipitating and alleviating factors.
+8 ;; 3. Estimate to what extent, if any, flair ups result in additional
+9 ;; limitation of motion or functional impairment.
+10 ;;
+11 ;;C. Physical Examination (Objective Findings):
+12 ;;Designate fingers as: thumb, index, long, ring, and little. Provide a detailed
+13 ;;assessment of each affected joint. State whether the individual is right
+14 ;;or left hand dominant. Use a goniometer for measuring joint angles. Refer to
+15 ;;Residuals of Amputations worksheet, if applicable.
+16 ;;
+17 ;; 1. Evaluation of Ankylosis
+18 ;;For each anklyosed joint, include angle of anklyosis. Describe any rotation or
+19 ;;any angulation of bone.
+20 ;;Zero degrees of flexion represents the fingers fully extended, making a
+21 ;;straight line with the rest of the hand.
+22 ;; The "position of function" of the hand is:
+23 ;; Wrist dorsiflexion: 20 to 30 degrees
+24 ;; Metacarpophalangeal flexion: 30 degrees
+25 ;; Proximal interphalangeal joint flexion: 30 degrees
+26 ;; Thumb abduction and rotation: thumb pad faces the finger pads.
+27 ;;
+28 ;; 2. Evaluation of Limitation of Motion of Single or Multiple Digits of the
+29 ;; Hand
+30 ;;Provide range of motion for each digit of the hand.
+31 ;;Normal Ranges of Motion for wrist, index, long, ring and little fingers:
+32 ;; Metacarpophalangeal joint (wrist): zero to 90 degrees of flexion
+33 ;; Proximal interphalangeal joint: zero to 100 degrees of flexion
+34 ;; Distal (terminal) interphalangeal joint: zero to 70 or 80 degrees of flexion
+35 ;;
+36 ;; 3. Evaluation of Hand as a unit
+37 ;;Measure the gap, in inches:
+38 ;; Between the tip of the thumb and the fingers
+39 ;; Between the tips of the fingers and the proximal transverse crease of the palm
+40 ;; Between the thumb pad and the fingers with the thumb attempting to oppose
+41 ;; the fingers
+42 ;; Describe strength for pushing, pulling and twisting. Describe dexterity for
+43 ;; twisting, probing, writing, touching and expression. Comment on whether and
+44 ;; how (e.g. decreased range of motion, in degrees) the flexion deformity
+45 ;; interferes with the function of the other fingers.
+46 ;;
+47 ;; 4. Additional detailed measurements and consideration of other factors
+48 ;; affecting function
+49 ;;Measure the active and passive range of motion of each affected joint. Include
+50 ;;movement against gravity and against strong resistance.
+51 ;;State whether and to what extent the range of motion (in degrees) or joint
+52 ;;function is additionally limited by pain, fatigue, weakness, or lack of
+53 ;;endurance following repetitive use or during flair-ups. If more than one
+54 ;;of these is present, state, if possible, which has the major functional
+55 ;;impact. Include rationale for conclusions.
+56 ;;
+57 ;; D. Diagnostic and Clinical Tests:
+58 ;;Include results of all diagnostic and clinical tests upon which examiner is
+59 ;;basing the diagnosis.
+60 ;;
+61 ;; E. Diagnosis:
+62 ;;
+63 ;;
+64 ;;
+65 ;;
+66 ;;Signature: Date:
+67 ;;END
