Swan Neck Deformity
Description
Swan neck occurs when the metacarpalphalangeal (MCP) joint is flexed, the proximal interphalangeal joint (PIP) is hyperextended, and the distal interphalangeal joint (DIP) is flexed. Motions that can be difficult to perform are flexing the PIP joint. This condition is associated in patients with rheumatoid arthritis because chronic inflammation of the PIP joint puts a stretch on the volar plate.
Signs & Symptoms
- Pain and swelling of the PIP joint
- DIP joint flexes forward and PIP joint hyperextends contributing to the swan neck description
Diagnostic Tests
- Physical examination from the clinician to assess the DIP and PIP joint
- X rays are not needed but it can help check the condition of the joint surfaces to see if a fracture is present
PT Implications
- Prevention and treatment include flexor digitorum superficialis (FDS) tendon glide at PIP joint and terminal extensor tendon glide at DIP joint
- Stretching can be done to reduce tightness in the other muscles around the fingers and hand
- Conservative treatment would be using a splint to prevent hyperextension of the finger and allow flexion of the PIP joint
- In extreme cases, surgery can be done to restore soft tissue around the PIP joint