. Physical diagnosis . FiG. 23.—Rachitic Epiphysitis. THE HANDS. 41 joint will be described below (see Examination of the joints,page 486). 5. Weephvg sinew or ganglion (tenosynovitis) forms a fluc-tuating, spindle-shaped swelling along one of the tendons of the. Fig. 2-1.—Hypertrophic Pulmonary Osteo-arthropathy. (Thayer.) wrist, slow and almost painless in its course. It may be tubercu-lous, in which case the sac is generally divided into several parts(compound ganglion ) ; bacilli may occasionally be demonstratedin the exudate. THE HANDS. I. Evidence of Occupation.—The horny, stiffened hand
. Physical diagnosis . FiG. 23.—Rachitic Epiphysitis. THE HANDS. 41 joint will be described below (see Examination of the joints,page 486). 5. Weephvg sinew or ganglion (tenosynovitis) forms a fluc-tuating, spindle-shaped swelling along one of the tendons of the. Fig. 2-1.—Hypertrophic Pulmonary Osteo-arthropathy. (Thayer.) wrist, slow and almost painless in its course. It may be tubercu-lous, in which case the sac is generally divided into several parts(compound ganglion ) ; bacilli may occasionally be demonstratedin the exudate. THE HANDS. I. Evidence of Occupation.—The horny, stiffened hands ofthe son of toil, the stains of paint in house painters, the flat-tened, calloused finger-tips of the violinist, the worn fingers of the 42 PHYSICAL DIAGNOSIS. sewing woman, afford us items of information which are sometimesuseful and. worth a rapid glance in routine examination. II. Temperature and Moisture.—(a) The cold, moist handis most commonly felt in nervous people under forty. It is almost never seen in heart dis-ease, which its possessor oftenfears, and does not meanpoor circulation, but vaso-motor disturbances of neuro-tic origin. (p) Cold, dry extremities—hands, feet, nose, ears—maymean simply fatigue, expos-ure to low temperature,
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