What your HANDS say about your HEALTH: Doctor Explains

hey guys I'm Siobhan an internal medicine and Rheumatology specialist so you know how people say that your eyes are the window into your soul well I'd argue that your hands are the window into your health seriously I can't tell you the number of times that I've examined a patient's hands and found something that helped me make the diagnosis I want to let you in on some of these secrets and show you some simple tests that you can do on your hands at home right now that may tell you something new about your health let's get into it this video is made for educational purposes only and should not be viewed as medical advice okay let's start with the thumb sign so make a fist with your thumb inside the way we're told never to punch and take a look does your thumb stick out the other side all the way until this joint and it doesn't count if you push it over like I'm doing okay now try the wrist sign so take your wrist and wrap your pinky and your thumb around it so mind touch but do yours overlap can your thumb completely cover the pinky nail if you can do these things you have arachnodactyly literally means spider like fingers long and slender and the first thing that I think about when someone has arachnodactyly is a genetic condition called Marfan syndrome so people with Mar fans have very long fingers and long arm span compared to their height and you can imagine there have been some incredible musicians and athletes with this condition like Rachmaninoff classical music fans out there know what I'm talking about he was a famous piano composer who played incredibly virtuosic pieces because of his long fingers so what's the problem then well the genetic mutation also affects elastic fibers in other organs and this can lead to a spontaneous pneumothorax where the lung basically pops and then collapses without any warning and even more concerning the aorta can dilate and even rupture which is life-threatening tragically some Elite athletes like Flo Hyman have actually died from this so if you just found out right now that you have a positive thumb sign and you have a positive wrist sign then talk to your doctor about getting genetic testing because then you can find out if you have Marfan syndrome and they can monitor your heart in case you need preventative surgery but Marfan syndrome isn't the only condition that causes arachnodactically it's also caused by ehlers-danlos syndrome okay time for another test put your hand on something flat and then bring your pinky back can it go past 90 degrees obviously mine cannot and now try another one take your thumb and see if you can bring it to your forearm this one I could actually do so these tests are looking for hypermobility particularly in the hand and that's one feature of ehlers-danlos syndrome or I usually just call it EDS it's a genetic condition that affects collagen and there are lots of different types of EDS but the most common one causes stretchy skin and really loose joints to the point that they can dislocate and come out of the socket the key is to strengthen the muscles around hypermobile joints to make them more stable and to prevent pain now there is one rare but very serious form of EDS called vascular EDS now this is when blood vessels and organs become stretchy and they can rupture or break so that could be an artery or a tendon even the uterus during pregnancy so usually this gets diagnosed when a young person comes in with a new aneurysm or they've got a family history and then they get genetic testing to confirm just remember that having a few hypermobile joints doesn't mean that you have EDS it's actually pretty common in women to be hyper mobile like look look at my wrist super flexible but I don't have EDS so don't panic now let's do some palm reading medical style and let's start by looking at the color of the Palm so if you notice that your palm is red especially around here it's called Palmer erythema and it's because the blood vessels get dilated the question is why the classic cause we always think about first is liver disease and usually pretty Advanced liver disease called liver cirrhosis but as a rheumatologist I see it all the time in patients with rheumatoid arthritis there's a huge long list of causes but in general I'd say if your palm has always looked red like that it's probably hereditary it's just the way you are and if you're pregnant that'll do it too but otherwise if it's something new you should probably get it checked out and get some blood work but sometimes the color of your palm changes because of your diet this woman ate so many tomatoes that her Palms actually turned Orange it's called lycopinemia because you get a buildup of lycopene in your skin which is an antioxidant that's found in tomatoes luckily it doesn't cause any permanent damage and after the woman started eating fewer Tomatoes her skin went back to normal after about a month so guys while I was prepping for this video I came across two things that never came up in my medical training and I was really intrigued and it actually even got me looking at my own hand so I gotta share them with you but first a reminder to subscribe and turn on the notification Bell if you like random medical topics and Hospital Vlogs okay so look at your hand and notice if your ring finger is longer or shorter than your index finger the length of your fingers was determined long before you were born and it has to do with the amount of testosterone you were exposed to as a fetus in the womb cool but what does that have to do with you well we don't know for sure but one study showed that men with a longer index finger and a shorter ring finger were actually less likely to develop prostate cancer and women with that same ratio longer index fingers shorter ring finger were more likely to develop breast cancer the research isn't strong enough yet to say that we should be measuring people's finger lengths in clinic and deciding if they need extra cancer screening but rather it's something interesting that may add to your own knowledge of your personal risk the other cool bit of research that I came across is a link between your fingerprint and your risk of high blood pressure and it's people with a whirl fingerprint pattern where it looks like a circle rather than a loop that are more likely to develop hypertension I've gotta say I don't think I've ever looked at my fingerprint before let alone a patients but I just thought it was so cool that I had to share it with you but on the flip side your fingernail actually says so much about your health I've got a whole other video about this talking about ridges and white marks so if you want to check that out after this video I'll leave a link in the comment section all right time for another test so put your hands like this with your palms and fingers fully touching now this would be abnormal it would be called a positive prayer sign and that's caused by anything that won't let your fingers and Palms fully extend there are many causes but the classic one is diabetes it's actually caused by sugar particles attaching to the collagen on your hand making it stiff so if I see this in a diabetic patient I really want to work hard with them to get their sugars under control and people with diabetes can have other issues with their hands as well like trigger finger or DuPage contractors or carpal tunnel syndrome which leads us to our next test okay so put the backs of your hands together relax your arms down and just hold it in that position until I tell you when to stop or until you get uncomfortable so with this maneuver we're trying to compress the median nerve which runs down your arm through the carpal tunnel to supply sensation to your thumb and first two fingers this carpal tunnel also has a bunch of tendons running through it so if any of them get swollen it puts pressure on the nerve causing numbness and tingling in these fingers so you've probably guessed this is carpal tunnel syndrome and it's super common usually caused by repetitive stress injuries like hairdressers commonly get it because they're always doing this movement but it can also be another sign line of a disease like hypothyroidism or rheumatoid arthritis if it gets severe enough you can actually see this muscle the thinner Eminence waste away and get really small usually you can fix this by resting Bringing Down the inflammation wearing splints and then later doing physiotherapy to prevent it from happening again but sometimes it becomes severe enough that you need surgery okay for those of you who are still holding your hands like this let them go do you have numbness tingling in these fingers if you do you should chat with your doctor to see if you have carpal tunnel syndrome okay now this time I've got a question for you have you ever been out in the cold and your fingers went completely white then maybe even turned blue and then when you warmed up they went beet red well this is called Reynolds phenomenon it's a condition where blood vessels clamp down and spasm an exaggerated response to the cold or even emotional stress but it can be one of the first signs of a connective tissue disease like Scleroderma which is a rare disease that causes thickening and hardening of the skin and even some internal organs so we're really aggressive to treat these patients and open up the blood vessels to prevent damage and one of the medications we actually use you may be surprised to hear is sildenafil also known as Viagra to help open up blood vessels I actually made a video with a woman named Claudia who lives with this condition and she was super open about the changes that have happened in her hands and around her face so if you want to learn more about it I'll leave a link up here but before a bunch of you freak out I want to remind you that if you have primary raynards the kind that started when you were a teenager and you're otherwise totally healthy you won't get ulcerations on your fingertips so don't worry all right we've got to talk about hand joints I'll admit it as a rheumatologist I am obsessed with examining people's hand joints we even have a little diagram in the office where we look at which joints are tender which ones are swollen we fill in the diagram we keep track of it for every visit normally a joint feels bony you can actually feel where they connect but if the joint is swollen it actually feels squishy kind of like a grape it can be painful too oh and if I do find a swollen joint I got to admit there's a small bit of me that's a bit excited because now we get to go hunting for the cause and there are over 100 types of arthritis and usually if you find inflammation in the joint there's inflammation in other parts of the body as well so really we're looking at the whole person to make a diagnosis but I digress I get too excited about this topic so let's get back to what your hands say about your health one important clue is the pattern of arthritis meaning which joints are involved so for example if I find arthritis in the dip joints the small little joints right by the nail there's only really two common causes for that psoriatic arthritis which is an arthritis that goes along with the skin condition psoriasis where people get that red flaky skin on their elbows knees and scalp or osteoarthritis which is the wear and tear arthritis that happens more with age but strangely enough rheumatoid arthritis never affects these little joints it can cause massive of damage to pretty much all the other joints in the hand but not those little ones so we consider the pattern of joints that are involved other symptoms the patient's having as well as blood work to piece it all together and then finally make a diagnosis sometimes it's obvious and we can make the diagnosis right away but other times it takes time and although that can be frustrating it's one of the parts the job that I love because when we do figure it out it's extremely satisfying not just for me but for the patient to have an answer for what's going on honestly I could keep talking about hands for hours but I'm going to leave it here if there's anything that I missed that you really want to learn about let me know in the comments below for the next video I'm back vlogging in the hospital so if you don't want to miss that turn on the notification Bell and I'll see you there so bye for now

Channel: Violin MD

Views: 1,148,663

Keywords: violinmd, violin md, life as a doctor, day in the life of a doctor, doctor vlog, life as a resident, life as a medical student, internal medicine, vlogging in the hospital, health secrets, joints, rheumatology, hand signs, hand doctor

Id: XKhrUVmtt-E

Length: 11min 31sec (691 seconds)

Published: Sat Mar 04 2023