Diagnosis
As a first step in diagnosing a ruptured capsule on the thumb, the doctor must be given some questions to answer. Among other things, he will want to know how the injury occurred and what symptoms are present. This is followed by an examination of the affected thumb.
The examiner looks at the joints and pays attention to swelling and malpositioning. He will also carefully palpate, check stability and, if necessary, test active and passive mobility. If the physician suspects an injury to bony parts, he will order an X-ray examination of the hand to prove or rule out the possibility.
Typical for a fracture is a painful compression. Further examinations such as an MRI should be reserved for justified exceptional cases. Magnetic resonance imaging (MRI) of the hand is a very costly and time-consuming form of examination, which is usually not indicated in the case of a torn capsule in the thumb.
The diagnosis can usually be made on the basis of the physical examination and the medical consultation. In most cases, treatment is carried out with rest and immobilization and the performance of the MRI would have no consequence for the treatment of the patient. Only in a few cases may it be appropriate to perform an MRI of the hand. If, for example, an injury is suspected that might require surgery, the MRI result can influence the decision for or against surgery.
Causes
A rupture of the capsule at the thumb occurs in most cases due to a violent hyperextension. This in turn can have various causes. Often such an injury occurs during sporting activities, whereby handball or volleyball in particular are associated with a high risk.
If a ball bounces against the stretched thumb, this can lead to an injury of the joint capsule. When skiing, typically getting stuck in a loop of the ski pole leads to a rupture of the capsule in the thumb, which is why it is called a “ski thumb” in such cases. In addition to sporting activities, however, the joint capsule can also easily be injured during everyday activities. Especially a fall on the thumb can cause damage.
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