. A practical treatise on medical diagnosis for students and physicians . Heberdens nodes. (Original.) 196 EXAMINATION OF THE EXTREMITIES. tractions due to chorea or to central lesions, as posthemiplegic contractions,will be considered under Special Diagnosis. It is thus seen that the peculiar combined extension and flexion, caus-ing abnormal shape of hands and fingers, may be due to (1) local joint- FiG. Rheumatoid arthritis. (Original.) inflammation (subluxations); (2) local neuritis and paralysis ; (3) pro-gressive (spinal) muscular atrophy; (4) or rarely idiopathic muscularatrophy. TH
. A practical treatise on medical diagnosis for students and physicians . Heberdens nodes. (Original.) 196 EXAMINATION OF THE EXTREMITIES. tractions due to chorea or to central lesions, as posthemiplegic contractions,will be considered under Special Diagnosis. It is thus seen that the peculiar combined extension and flexion, caus-ing abnormal shape of hands and fingers, may be due to (1) local joint- FiG. Rheumatoid arthritis. (Original.) inflammation (subluxations); (2) local neuritis and paralysis ; (3) pro-gressive (spinal) muscular atrophy; (4) or rarely idiopathic muscularatrophy. THE HANDS. Shape. We bear in mind the variation in the shape of the handin different types of individuals—the broad and heavy hand of the san-guine, the slender, dexterous hand of an individual of the nervous tem-perament (see Chapter XIX., Part I.), the large joints of the hand of Fig. 29. Pseudomuscular atrophy. Claw-hand. (Gray.) so-called strumous persons, and the effeminate hand of one who is inclinedto tuberculosis, present sharp contrasts. Then, too, the occupation hand indicates in a general way the disease the patient is liable to—nonemore striking than the hand of the miner, the blue-black dottings of THE HANDS. 197 which clearly indicate tiie possibility of anthracosis. Finally, we notethe broad hand and clubbed fingers that are seen in congenital heartdisease. The withered hand of age and
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