Examination of the hands: an insight into the health of a Welsh population
- 1Department of Medicine, University of Wales College of Medicine, Cardiff
- 2Department of Medicine, Royal Glamorgan Hospital, Ynysmaerdy, Mid Glamorgan
- Correspondence to: Dr J C Alcolado Department of Medicine, University of Wales College of Medicine, Heath Park, Cardiff CF14 4XN, UK; Alcoladobtinternet.com
- Received 27 January 2003
- Accepted 12 February 2003
Abstract
When asked to examine a patient in a clinical examination, undergraduates and postgraduates characteristically begin with a painstaking observation of the hands. It was of concern that this is done mainly for the benefit of the examiners and that, in routine clinical practice, examination of the hands receives scant attention. The case notes of 70 general medical and surgical inpatients were reviewed and it was found that in only seven was there any mention of physical examination of the hands; in three of these “no clubbing” was the only entry. However, when the authors carefully examined the hands of 197 patients, at least one clinical sign was found in 87 (44%) cases. Heberden’s nodes, cigarette tar staining, and the spectrum of Dupuytren’s contractures were the most common findings. In this population in the South Wales valleys, coal deposits were also commonly seen in men.
