(BQ) Continued part 1, part 2 of the document A handbook of general practice (Seventh edition) has contents: The disturbed patient, dysphagia, the painful ear, the red and tender eye, haematemesis and melaena, nasal disorders, neck lumps, the painful knee, pain in the foot and ankle,. and other contents. Invite you to refer. | A handbook of general practice (Seventh edition): Part 2 Page 722 CHAPTER 64 Pain in the arm and hand A pain in the hand is worth a look at the neck. By heck don’t forget the neck! ORTHOPAEDIC SURGEON TO STUDENTS, 1965 Pain in the arm and hand is a common problem in general practice, tending to affect the middle aged and elderly in particular. Overview of causes of a painful arm and hand Like pain in the shoulder, pain originating from the cervical spine and shoulder disorders can extend down the arm. While pain from disorders of the shoulder joint (because of its C5 innervation) does not usually extend below the elbow, radiculopathies originating in the cervical spine can transmit to distal parts of the arm (see FIG. , later in this chapter). Important causes are illustrated in FIGURE . Myocardial ischaemia must be considered, especially for pain experienced down the inner left arm. FIGURE Important causes of arm pain (excluding trauma and arthritis) Soft tissue disorders of the elbow are extremely common, especially tennis elbow. Two types of tennis elbow are identifiable: ‘backhand’ tennis elbow, or lateral epicondylitis, and ‘forehand’ tennis elbow, or medial epicondylitis, which is known also as golfer’s or pitcher’s elbow. Other significant elbow disorders include inflammatory disorders of the elbow joint, such as rheumatoid arthritis, osteoarthritis and olecranon bursitis, which may follow recurrent trauma, gout, rheumatoid arthritis or infection. Another important group of disorders are the various regional pain syndromes around the wrists, including the common de Quervain tenosynovitis (affecting the tendons of extensor pollicis brevis and abductor pollicis longus) and to a lesser extent the extensor tendons to the fingers. Pain from these overuse syndromes can be referred in a retrograde manner into the forearm. A fascinating and poorly understood syndrome is that related .
