camptodactyly

PIP flexion phenotype

Camptodactyly typically involves incomplete PIP extension; some affected joints remain passively correctable. [Boston Children's Hospital](https://www.childrenshospital.org/sites/default/files/2022-04/camptodactyly-factsheet.pdf)

1. Which fingers and joints show persistent flexion, and on which hand? measurement
2. Can each affected PIP joint straighten actively, passively, both or neither? measurement

Diagnostic attribution

Keep the observed posture separate from the clinician's diagnostic interpretation.

1. Is the principal abnormality PIP flexion, sideways angulation, or a different joint pattern? boundary
2. What history or examination evidence supports an alternative involving injury, scarring, inflammation or triggering? boundary
3. Who established the diagnosis, when, and what uncertainty remains? provenance

Onset evidence

Use dated observations rather than inferring congenital onset from the diagnostic label.

1. When was the bend first observed, and is there evidence of an earlier normal or abnormal posture? provenance
2. Did the finger posture change during a documented period of rapid growth? measurement

Isolated or associated presentation

Family history or a wider syndrome may accompany camptodactyly; either association needs its own evidence. [Boston Children's Hospital](https://www.childrenshospital.org/sites/default/files/2022-04/camptodactyly-factsheet.pdf)

1. Which relatives have a comparable finger phenotype, and was it examined or only reported? provenance
2. What additional contractures or extra-hand findings support assessment for an associated syndrome? boundary
3. Is a syndrome confirmed, suspected or unassessed, and which separate model should own it? boundary

Comparable motion record

Document measurement conditions so apparent progression can be distinguished from examination variation.

1. What are the active and passive PIP extension deficits and available flexion, in degrees? measurement
2. Were wrist position, adjacent-joint position and measurement method comparable with the previous assessment? measurement
3. What observed change supports stable, worsening, improving or recurrent status? measurement

Patient-important effects

Camptodactyly may have little pain or functional effect; record individual burden rather than assuming disability from appearance. [Children's Hospital of Philadelphia](https://www.chop.edu/conditions-diseases/camptodactyly)

1. Which tasks are affected, such as gripping, releasing objects, writing or putting on gloves? measurement
2. What matters most to the person: function, appearance, comfort or preventing further change? action
3. Are pain, swelling, warmth or sensory symptoms present, and do they require investigation beyond the contracture? boundary

Individualised care plan

Care can include stretching, splinting or surgery, with selection informed by severity and function. [Children's Hospital of Philadelphia](https://www.chop.edu/conditions-diseases/camptodactyly)

1. What findings and goals justify the clinician's current choice of observation, therapy or surgical assessment? action
2. What stretching or splint programme was prescribed, and what was actually completed and tolerated? provenance
3. What change should prompt an earlier review, and who is responsible for follow-up? action

Balanced treatment outcome

Residual curvature and stiffness can remain after surgery, so outcome assessment must include retained movement. [Boston Children's Hospital](https://www.childrenshospital.org/sites/default/files/2022-04/camptodactyly-factsheet.pdf)

1. How did active extension, passive extension, flexion and priority tasks change from the pretreatment baseline? measurement
2. Is there residual or recurrent contracture, new stiffness, pain or difficulty using the finger? measurement
3. Does the observed benefit justify continuing or revising the plan at clinician review? action

Check these first

Recalled without web access and unsourced; every item is a lead to verify.

1. Which of these check these first hold for the sense of camptodactyly this model covers, and on what evidence? provenance

Kinds and varieties

Recalled without web access and unsourced; every item is a lead to verify.

1. Which of these kinds and varieties hold for the sense of camptodactyly this model covers, and on what evidence? provenance

Real-world use

Recalled without web access and unsourced; every item is a lead to verify.

1. Which of these real-world use hold for the sense of camptodactyly this model covers, and on what evidence? provenance

Typical measurements

Recalled without web access and unsourced; every item is a lead to verify.

1. Which of these typical measurements hold for the sense of camptodactyly this model covers, and on what evidence? provenance

Failure modes and hazards

Recalled without web access and unsourced; every item is a lead to verify.

1. Which of these failure modes and hazards hold for the sense of camptodactyly this model covers, and on what evidence? provenance

Neighbouring kinds and how to tell them apart

Recalled without web access and unsourced; every item is a lead to verify.

1. Which of these neighbouring kinds and how to tell them apart hold for the sense of camptodactyly this model covers, and on what evidence? provenance