{"id":40489,"date":"2020-09-22T12:22:19","date_gmt":"2020-09-22T06:52:19","guid":{"rendered":"https:\/\/johnsonfrancis.org\/professional\/?p=40489"},"modified":"2021-12-28T15:39:54","modified_gmt":"2021-12-28T10:09:54","slug":"general-examination-hands-and-feet","status":"publish","type":"post","link":"https:\/\/johnsonfrancis.org\/professional\/general-examination-hands-and-feet\/","title":{"rendered":"General examination &#8211; hands and feet"},"content":{"rendered":"<h2><span style=\"color: #008000;\">General examination &#8211; hands and feet<\/span><\/h2>\n<p>Cyanosis and pallor can be noted in the tips of the digits. Severe jaundice may be visible in the palms and soles, especially in small infants.<\/p>\n<ul>\n<li><em>Clubbing<\/em> of digits may be noted in cyanotic heart diseases as well many other non cardiac conditions. In clubbing, initially there is fluctuation of nail bed (Grade 1) followed by obliteration of angle between nail and adjacent skin fold (<em>Lovibond angle<\/em> \u2013 Grade 2). Later there is curvature of the nails (<em>parrot beaking<\/em> \u2013 Grade 3). Grade 4 or hypertrophic osteoarthropathy is not common in cardiovascular causes of clubbing, hence the term hypertrophic pulmonary osteoarthropathy. It is a triad of periostitis, digital clubbing and painful arthropathy of the large joints, classical of lung cancer.<\/li>\n<\/ul>\n<figure id=\"attachment_52826\" aria-describedby=\"caption-attachment-52826\" style=\"width: 827px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-52826\" src=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2020\/09\/Lovibond-angle.png\" alt=\"Lovibond angle\" width=\"827\" height=\"510\" srcset=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2020\/09\/Lovibond-angle.png 827w, https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2020\/09\/Lovibond-angle-300x185.png 300w, https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2020\/09\/Lovibond-angle-768x474.png 768w\" sizes=\"auto, (max-width: 827px) 100vw, 827px\" \/><figcaption id=\"caption-attachment-52826\" class=\"wp-caption-text\">Lovibond angle<\/figcaption><\/figure>\n<ul>\n<li><em>Osler\u2019s nodes<\/em> are tender reddish spots on the distal aspects of the fingers and toes, noted in infective endocarditis.<\/li>\n<li><em>Janeway lesions<\/em> are non tender erythematous patches on the palms and soles, seen in in infective endocarditis.<\/li>\n<li><em>Heberden\u2019s nodes<\/em> are bony outgrowths from the margin of the distal interphalangeal joints, a feature of osteoarthritis.<\/li>\n<li><em>Splinter hemorrhages<\/em> are linear streaks in the nail bed, typically seen in infective endocarditis, though it can also occur with trauma.<\/li>\n<\/ul>\n<figure id=\"attachment_52829\" aria-describedby=\"caption-attachment-52829\" style=\"width: 785px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-52829\" src=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2020\/09\/Splinter-hemorrhage.jpg\" alt=\"Splinter hemorrhage\" width=\"785\" height=\"304\" srcset=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2020\/09\/Splinter-hemorrhage.jpg 785w, https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2020\/09\/Splinter-hemorrhage-300x116.jpg 300w, https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2020\/09\/Splinter-hemorrhage-768x297.jpg 768w\" sizes=\"auto, (max-width: 785px) 100vw, 785px\" \/><figcaption id=\"caption-attachment-52829\" class=\"wp-caption-text\">Splinter hemorrhage<\/figcaption><\/figure>\n<ul>\n<li><em>Dupuytren&#8217;s contracture<\/em> which affects the ring and little finger may be associated with cirrhosis of the liver, though it can occur without cirrhosis as well.<\/li>\n<li><em>Arachnodactyly <\/em>or long slender digits resembling those of arachnids (spider family) is a feature of Marfan syndrome.<\/li>\n<li><em>Polydactyly <\/em>with extra digits is part of Ellis-Van Creveld syndrome which has in addition short stature and cyanotic congenital heart disease (single atrium).<\/li>\n<li><em style=\"font-size: inherit;\">Edema <\/em><span style=\"font-size: inherit;\">is collection of fluid in the subcutaneous tissue. If it is unilateral, the cause is local like lymphedema or deep vein thrombosis (clotting of blood in deep veins of the legs). <\/span><em style=\"font-size: inherit;\">Pitting edema<\/em> is demonstrated by sustained pressure over the lower part of tibia to displace the fluid and form a pit. Long standing edema may be non pitting. Bilateral pedal edema can occur in cardiac, renal or hepatic failure as well as hypoproteinemia and hypothyroidism.<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>General examination &#8211; hands and feet Cyanosis and pallor can be noted in the tips of the digits. Severe jaundice may be visible in the palms and soles, especially in small infants. Clubbing of digits may be noted in cyanotic heart diseases as well many other non cardiac conditions. In clubbing, initially there is fluctuation [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":40490,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","footnotes":""},"categories":[10],"tags":[1664,1974,2222,2710,2895,2921],"class_list":["post-40489","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-hbc","tag-heberdens-nodes","tag-janeway-lesions","tag-lovibond-angle","tag-oslers-nodes","tag-pitting-edema","tag-polydactyly"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.7 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>General examination - hands and feet - All About Cardiovascular System and Disorders<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/johnsonfrancis.org\/professional\/general-examination-hands-and-feet\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"General examination - hands and feet - All About Cardiovascular System and Disorders\" \/>\n<meta property=\"og:description\" content=\"General examination &#8211; hands and feet Cyanosis and pallor can be noted in the tips of the digits. Severe jaundice may be visible in the palms and soles, especially in small infants. Clubbing of digits may be noted in cyanotic heart diseases as well many other non cardiac conditions. In clubbing, initially there is fluctuation [&hellip;]\" \/>\n<meta property=\"og:url\" content=\"https:\/\/johnsonfrancis.org\/professional\/general-examination-hands-and-feet\/\" \/>\n<meta property=\"og:site_name\" content=\"All About Cardiovascular System and Disorders\" \/>\n<meta property=\"article:published_time\" content=\"2020-09-22T06:52:19+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2021-12-28T10:09:54+00:00\" \/>\n<meta name=\"author\" content=\"Johnson Francis\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Johnson Francis\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"2 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/general-examination-hands-and-feet\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/general-examination-hands-and-feet\\\/\"},\"author\":{\"name\":\"Johnson Francis\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"headline\":\"General examination &#8211; hands and feet\",\"datePublished\":\"2020-09-22T06:52:19+00:00\",\"dateModified\":\"2021-12-28T10:09:54+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/general-examination-hands-and-feet\\\/\"},\"wordCount\":363,\"publisher\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"image\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/general-examination-hands-and-feet\\\/#primaryimage\"},\"thumbnailUrl\":\"\",\"keywords\":[\"Heberden\u2019s nodes\",\"Janeway lesions\",\"Lovibond angle\",\"Osler\u2019s nodes\",\"Pitting edema\",\"Polydactyly\"],\"articleSection\":[\"HBC\"],\"inLanguage\":\"en-US\"},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/general-examination-hands-and-feet\\\/\",\"url\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/general-examination-hands-and-feet\\\/\",\"name\":\"General examination - hands and feet - All About Cardiovascular System and Disorders\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/general-examination-hands-and-feet\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/general-examination-hands-and-feet\\\/#primaryimage\"},\"thumbnailUrl\":\"\",\"datePublished\":\"2020-09-22T06:52:19+00:00\",\"dateModified\":\"2021-12-28T10:09:54+00:00\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/general-examination-hands-and-feet\\\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/general-examination-hands-and-feet\\\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/general-examination-hands-and-feet\\\/#primaryimage\",\"url\":\"\",\"contentUrl\":\"\"},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/general-examination-hands-and-feet\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"General examination &#8211; hands and feet\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#website\",\"url\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/\",\"name\":\"All About Cardiovascular System and Disorders\",\"description\":\"\",\"publisher\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"},{\"@type\":[\"Person\",\"Organization\"],\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\",\"name\":\"Johnson Francis\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g\",\"url\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g\",\"contentUrl\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g\",\"caption\":\"Johnson Francis\"},\"logo\":{\"@id\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g\"},\"description\":\"Former Professor of Cardiology, Calicut Govt. Medical Kozhikode, Kerala, India. Editor-in-Chief, BMH Medical Journal\",\"url\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/author\\\/jf\\\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"General examination - hands and feet - All About Cardiovascular System and Disorders","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/johnsonfrancis.org\/professional\/general-examination-hands-and-feet\/","og_locale":"en_US","og_type":"article","og_title":"General examination - hands and feet - All About Cardiovascular System and Disorders","og_description":"General examination &#8211; hands and feet Cyanosis and pallor can be noted in the tips of the digits. Severe jaundice may be visible in the palms and soles, especially in small infants. Clubbing of digits may be noted in cyanotic heart diseases as well many other non cardiac conditions. In clubbing, initially there is fluctuation [&hellip;]","og_url":"https:\/\/johnsonfrancis.org\/professional\/general-examination-hands-and-feet\/","og_site_name":"All About Cardiovascular System and Disorders","article_published_time":"2020-09-22T06:52:19+00:00","article_modified_time":"2021-12-28T10:09:54+00:00","author":"Johnson Francis","twitter_card":"summary_large_image","twitter_misc":{"Written by":"Johnson Francis","Est. reading time":"2 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/johnsonfrancis.org\/professional\/general-examination-hands-and-feet\/#article","isPartOf":{"@id":"https:\/\/johnsonfrancis.org\/professional\/general-examination-hands-and-feet\/"},"author":{"name":"Johnson Francis","@id":"https:\/\/johnsonfrancis.org\/professional\/#\/schema\/person\/5441d907049b914770f4bd98fb57feec"},"headline":"General examination &#8211; hands and feet","datePublished":"2020-09-22T06:52:19+00:00","dateModified":"2021-12-28T10:09:54+00:00","mainEntityOfPage":{"@id":"https:\/\/johnsonfrancis.org\/professional\/general-examination-hands-and-feet\/"},"wordCount":363,"publisher":{"@id":"https:\/\/johnsonfrancis.org\/professional\/#\/schema\/person\/5441d907049b914770f4bd98fb57feec"},"image":{"@id":"https:\/\/johnsonfrancis.org\/professional\/general-examination-hands-and-feet\/#primaryimage"},"thumbnailUrl":"","keywords":["Heberden\u2019s nodes","Janeway lesions","Lovibond angle","Osler\u2019s nodes","Pitting edema","Polydactyly"],"articleSection":["HBC"],"inLanguage":"en-US"},{"@type":"WebPage","@id":"https:\/\/johnsonfrancis.org\/professional\/general-examination-hands-and-feet\/","url":"https:\/\/johnsonfrancis.org\/professional\/general-examination-hands-and-feet\/","name":"General examination - hands and feet - All About Cardiovascular System and Disorders","isPartOf":{"@id":"https:\/\/johnsonfrancis.org\/professional\/#website"},"primaryImageOfPage":{"@id":"https:\/\/johnsonfrancis.org\/professional\/general-examination-hands-and-feet\/#primaryimage"},"image":{"@id":"https:\/\/johnsonfrancis.org\/professional\/general-examination-hands-and-feet\/#primaryimage"},"thumbnailUrl":"","datePublished":"2020-09-22T06:52:19+00:00","dateModified":"2021-12-28T10:09:54+00:00","breadcrumb":{"@id":"https:\/\/johnsonfrancis.org\/professional\/general-examination-hands-and-feet\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/johnsonfrancis.org\/professional\/general-examination-hands-and-feet\/"]}]},{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/johnsonfrancis.org\/professional\/general-examination-hands-and-feet\/#primaryimage","url":"","contentUrl":""},{"@type":"BreadcrumbList","@id":"https:\/\/johnsonfrancis.org\/professional\/general-examination-hands-and-feet\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/johnsonfrancis.org\/professional\/"},{"@type":"ListItem","position":2,"name":"General examination &#8211; hands and feet"}]},{"@type":"WebSite","@id":"https:\/\/johnsonfrancis.org\/professional\/#website","url":"https:\/\/johnsonfrancis.org\/professional\/","name":"All About Cardiovascular System and Disorders","description":"","publisher":{"@id":"https:\/\/johnsonfrancis.org\/professional\/#\/schema\/person\/5441d907049b914770f4bd98fb57feec"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/johnsonfrancis.org\/professional\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"},{"@type":["Person","Organization"],"@id":"https:\/\/johnsonfrancis.org\/professional\/#\/schema\/person\/5441d907049b914770f4bd98fb57feec","name":"Johnson Francis","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/secure.gravatar.com\/avatar\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g","url":"https:\/\/secure.gravatar.com\/avatar\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g","contentUrl":"https:\/\/secure.gravatar.com\/avatar\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g","caption":"Johnson Francis"},"logo":{"@id":"https:\/\/secure.gravatar.com\/avatar\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g"},"description":"Former Professor of Cardiology, Calicut Govt. Medical Kozhikode, Kerala, India. Editor-in-Chief, BMH Medical Journal","url":"https:\/\/johnsonfrancis.org\/professional\/author\/jf\/"}]}},"amp_enabled":true,"_links":{"self":[{"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/posts\/40489","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/comments?post=40489"}],"version-history":[{"count":2,"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/posts\/40489\/revisions"}],"predecessor-version":[{"id":52830,"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/posts\/40489\/revisions\/52830"}],"wp:attachment":[{"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/media?parent=40489"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/categories?post=40489"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/tags?post=40489"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}