Knuckle Health Dictionary

A rare autoimmune disorder in which the muscles and skin become inflamed. It causes a skin rash first on the bridge of the nose and cheeks, followed by a purple discoloration on the eyelids and sometimes a red rash on the knees, knuckles, and elbows. Muscles become weak, stiff, and painful, particularly those in the shoulders and pelvis.

Treatment is with corticosteroid drugs and/or immunosuppressant drugs and physiotherapy. In about 50 per cent of cases, full recovery occurs after a few years. The remainder have persistent muscle weakness. In about 20 per cent, it eventually affects the lungs and other organs and may be fatal.... dermatomyositis

Chromic acid is used in several industries, particularly in chromium plating. Unless precautions are taken it may lead to dermatitis of the hands, arms, chest and face. It may also cause deep ulcers, especially of the nasal septum and knuckles.... chromic acid

The term ‘eating disorders’ covers OBESITY, feeding problems in childhood, anorexia nervosa, and bulimia nervosa. The latter two are described here.

Anorexia nervosa Often called the slimmer’s disease, this is a syndrome characterised by the loss of at least a quarter of a person’s normal body weight; by fear of normal weight; and, in women, by AMENORRHOEA. An individual’s body image may be distorted so that the sufferer cannot judge real weight and wants to diet even when already very thin.

Anorexia nervosa usually begins in adolescence, affecting about 1–2 per cent of teenagers and college students at any time. It is 20 times more common among women than men. Up to 10 per cent of sufferers’ sisters also have the syndrome. Anorexia may be linked with episodes of bulimia (see below).

The symptoms result from secretive self-starvation, usually with excessive exercise, self-induced vomiting, and misuse of laxatives. An anorexic (or anorectic) person may wear layers of baggy clothes to keep warm and to hide the ?gure. Starvation can cause serious problems such as ANAEMIA, low blood pressure, slow heart rate, swollen ankles, and osteoporosis. Sudden death from heart ARRHYTHMIA may occur, particularly if the sufferer misuses DIURETICS to lose weight and also depletes the body’s level of potassium.

There is probably no single cause of anorexia nervosa. Social pressure to be thin seems to be an important factor and has increased over the past 20–30 years, along with the incidence of the syndrome. Psychological theories include fear of adulthood and fear of losing parents’ attention.

Treatment should start with the general practitioner who should ?rst rule out other illnesses causing similar signs and symptoms. These include DEPRESSION and disorders of the bowel, PITUITARY GLAND, THYROID GLAND, and OVARIES.

If the diagnosis is clearly anorexia nervosa, the general practitioner may refer the sufferer to a psychiatrist or psychologist. Moderately ill sufferers can be treated by COGNITIVE BEHAVIOUR THERAPY. A simple form of this is to agree targets for daily calorie intake and for acceptable body weight. The sufferer and the therapist (the general practitioner or a member of the psychiatric team) then monitor progress towards both targets by keeping a diary of food intake and measuring weight regularly. Counselling or more intensely personal PSYCHOTHERAPY may help too. Severe life-threatening complications will need urgent medical treatment in hospital, including rehydration and feeding using a nasogastric tube or an intravenous drip.

About half of anorectic sufferers recover fully within four years, a quarter improve, and a quarter remain severely underweight with (in the case of women) menstrual abnormalities. Recovery after ten years is rare and about 3 per cent die within that period, half of them by suicide.

Bulimia nervosa is a syndrome characterised by binge eating, self-induced vomiting and laxative misuse, and fear of fatness. There is some overlap between anorexia nervosa and bulimia but, unlike the former, bulimia may start at any age from adolescence to 40 and is probably more directly linked with ordinary dieting. Bulimic sufferers say that, although they feel depressed and guilty after binges, the ‘buzz’ and relief after vomiting and purging are addictive. They often respond well to cognitive behaviour therapy.

Bulimia nervosa does not necessarily cause weight loss because the binges – for example of a loaf of bread, a packet of cereal, and several cans of cold baked beans at one sitting – are cancelled out by purging, by self-induced vomiting and by brief episodes of starvation. The full syndrome has been found in about 1 per cent of women but mild forms may be much more common. In one survey of female college students, 13 per cent admitted to having had bulimic symptoms.

Bulimia nervosa rarely leads to serious physical illness or death. However, repeated vomiting can cause oesophageal burns, salivary gland infections, small tears in the stomach, and occasionally dehydration and chemical imbalances in the blood. Inducing vomiting using ?ngers may produce two tell-tale signs – bite marks on the knuckles and rotten, pitted teeth.

Those suffering from this condition may obtain advice from the Eating Disorders Association.... eating disorders

In structure, the hand has a bony basis of eight small carpal bones in the wrist, ?ve metacarpal bones in the ?eshy part of the hand, and three phalanges in each ?nger – two only in the thumb. From the muscles of the forearm, 12 strong tendons run in front of the wrist. Of these, nine go to the ?ngers and thumb and are bound down by a strong band, the ?exor retinaculum, in front of the wrist. They are enclosed in a complicated synovial sheath, and pass through the palm and down the ?ngers. Behind the wrist, 12 tendons likewise cross from forearm to hand.

Forming the ball of the thumb and that of the little ?nger, and ?lling up the gaps between the metacarpal bones, are other muscles, which act to separate and bring together the ?ngers, and to bend them at their ?rst joints (knuckles).... hand

The ?ve long bones which occupy the HAND between the carpal bones at the wrist and the phalanges of the ?ngers. The large rounded ‘knuckles’ at the root of the ?ngers are formed by the heads of these bones.... metacarpal bones

One of 5 long, cylindrical bones within the hand. The bones run from the wrist to the base of each digit, with the heads of the bones forming the knuckles.... metacarpal bone

the combination of features, often found in the hands of long-standing diabetic subjects, consisting of *Dupuytren’s contractures, knuckle pads, *carpal tunnel syndrome, *cheiroarthropathy, and sclerosing *tenosynovitis.... diabetic hand syndrome

Bony out-cropping from the surface of a bone. May appear in those with gouty tendencies as small unsightly lumps on knuckles, toes or upper edges of lobes of the ears. Not painful, except on pressure. Existing nodules cannot be reduced but future ones may be prevented by herbs known to facilitate elimination of excess uric acid from the body: Guaiacum, Sarsaparilla, Celery seed, Dandelion root. Turkey Rhubarb.

Teas: Celery seed, Meadowsweet, Yarrow. Yerba Mate.

Tincture Rhei Co BP (1948). 30-60 drops in water thrice daily.

Burdock and Sarsaparilla health drink.

Liquid Extract: Guaiacum: 5-10 drops in water thrice daily.

Diet. Low protein (especially fish and shellfish). Dandelion coffee. Vegetable juices. Reject alcohol, coffee, strong tea. ... exostosis