Abnormal Gait & Hand Stiffness & Progressive Contractures: Causes & Reasons

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Patient File

Sex unknown, Age unknown

Reported Symptoms

Abnormal Gait, Hand Stiffness, Progressive Contractures,

Negated

None

Unsure

None

Possible Causes

Osteoarthritis

walking or bending the joint Some patients with osteoarthritis also develop a bone spur (a bony protrusion) at the affected joint. [foothealthfacts.org]

Another characteristic symptom of the disease is the progressive inability of joint function, leading -in the long run- to loss of mobility. [oafifoundation.com]

Fingers and Hands When OA occurs in hands and fingers, you may experience stiffness, numbness, and aching. [arthritis.com]

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Arthritis

This case report describes the findings of a previously healthy pediatric patient with acute onset of knee swelling and abnormal gait. [ncbi.nlm.nih.gov]

Dupuytren’s contracture tends to affect the pinkie and ring fingers and generally progresses very slowly. [medicalnewstoday.com]

— Aurelie Corinthios, PEOPLE.com, "Kim Kardashian Tells Grandma MJ About Her 'Stiff' Hands During Lupus Scare in KUWTK Bonus Scene," 27 Dec. 2019 The exhibit illustrates [merriam-webster.com]

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Winchester Syndrome

Elevated IL1-beta Elevated IL6 Elevated antinuclear antibody (ANA) (speckled pattern) Performance Abnormal gait Skeletal Carpal osteolysis Fusiform finger swelling Interphalangeal [datagenno.com]

The syndrome is characterized by dissolution of carpal and tarsal bones with generalized osteoporosis, progressive joint contractures, short stature, peripheral corneal opacities [ncbi.nlm.nih.gov]

External references: 2 OMIM references - 1 MeSH reference: C536051 Very frequent - Arthritis / synovitis / synovial proliferation - Autosomal recessive inheritance - Claw hand [csbg.cnb.csic.es]

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Muscular Dystrophy

gait, muscle pains, calf hypertrophy, unexplained elevated liver enzymes, learning difficulties, behavioural problems, or speech and language delay Test for creatine kinase [bmj.com]

In DMD and some cases of BMD there is progressive weakness, contractures and the inability to walk. [healthengine.com.au]

Adults with later-onset type 2 myotonic dystrophy can have stiffness and myotonia in the thighs and hands, neck weakness, and hip weakness with trouble climbing stairs. [jamanetwork.com]

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Polyarthritis

A 72-year-old retired Caucasian man arrived at the emergency department with confusion, a temperature of 101 F, difficulty walking, leukocytosis, and diffuse joint aches. [ncbi.nlm.nih.gov]

The characteristic rapid progression of palmar contracture is a key finding that suggests the potential existence of a malignancy. [Indexed for MEDLINE] Free full text [ncbi.nlm.nih.gov]

CASE 2 A 86 year old white man presented with a three week history of severe swelling of the right hand associated with pain and morning stiffness. [ard.bmj.com]

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Coxa Vara

Many patients have persistent gait abnormalities and functional impairment at long-term follow-up, regardless of prior treatment. [ncbi.nlm.nih.gov]

[…] dysfunction, and joint contractures. [ncbi.nlm.nih.gov]

[…] in the hands. [rrnursingschool.biz]

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Supination Injury

If you underpronate while you walk, you may notice arch pain, heel pain, and even back and knee pain because of the additional stress this abnormal gait places on the body [heelthatpain.com]

[…] to a ﬁxed supination contracture as interosseous membrane stiffness, muscle shortening, and joint stiffness increases.10 The posture in forearm supination presents serious [kundoc.com]

On the other hand, too much dorsiflexion is also problematic. [draxe.com]

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Internal Joint Prosthesis Broken

These maneuvers lead to an abnormal gait and require extra effort and concentration. [aetna.com]

As one progresses distally to the midthigh level, it is increasingly difficult to compensate prosthetically for a hip flexion contracture. [oandplibrary.org]

[…] work in hand therapy. [davidlnelson.md]

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Mucopolysaccharidosis

Hypermobile joints and an abnormal gait with a tendency to fall may also be presenting features. [genedx.com]

hip containment surgeries; corrective osteotomy for progressive valgus deformity at the knee; posterior spinal fusion Multispecialty care is mandatory for these patients [emedicine.medscape.com]

Short and often claw-like hands, progressive joint stiffness, and carpal tunnel syndrome can restrict hand mobility and function. [en.wikipedia.org]

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Osteoarthritis of the Knee

As noted earlier, this change in internal loading patterns has the potential to cause excessive external subtalar joint pronation moments, abnormal gait patterns and even [podiatrytoday.com]

knee ROM, medial BMLs, medial subchondral bone cysts and medial trabecular bone texture are associated with the cOA progression. [arthritis-research.biomedcentral.com]

[…] knobs at the middle finger joints (known as Bouchard's nodes ) and at the farthest finger joints (known as Heberden's nodes ) are a common feature of osteoarthritis in the hands [en.wikipedia.org]

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Becker Muscular Dystrophy

GENE INCLUDED: DMD INDICATIONS FOR TESTING: Developmental delay Gross motor delay or loss of motor skills Low muscle tone Calf hypertrophy Abnormal gait Dilated cardiomyopathy [unmc.edu]

Progressive scoliosis and contracture formation may require surgical intervention. [emedicine.medscape.com]

The symptoms include: Weakness in the muscles of the face, arms, hands, and neck Muscle stiffness (myotonia) -- difficulty relaxing the muscles after they are tightened Shrinking [webmd.com]

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Stiff-Person Syndrome

They reported observations from 14 cases of patients who experienced progressive stiffness, episodic painful muscle spasms, and difficulty walking without any other neurological [physio-pedia.com]

The syndrome began as muscle stiffness in her lower extremities and insidiously progressed to a state of constant stiffness resulting in permanent contractures of her lower [journals.lww.com]

More rarely, the hands can be affected jerking stiff person syndrome - otherwise known as progressive encephalomyelitis with rigidity - is the rarest form of SMS. [cafamily.org.uk]

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Cerebral Palsy

These comorbidities include intellectual disabilities, seizures, muscle contractures, abnormal gait, osteoporosis, communication disorders, malnutrition, sleep disorders, [ncbi.nlm.nih.gov]

Orthopaedic problems: eg, progressive joint contractures, shortened muscles, hip or foot deformities and scoliosis. [patient.info]

People will experience increased muscle tone and their movements may appear stiff or awkward. [yourcpf.org]

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Limb-Girdle Muscular Dystrophy Type 2A

COMMON Features of the Disorder Difficulty walking Wheelchair assistance Scoliosis Joint contractures Muscle cramps Exercise intolerance Cardiomyopathy (weak heart muscles [evolvegene.com]

There is variable rate of progression. May develop myalgia, myoglobinuria, contractures, muscle hypertrophy. [patient.info]

[…] of distal muscles of the body such as those controlling the hands and feet. [mda.org]

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Amyotrophic Lateral Sclerosis

He had difficulty walking due to poor movement of his right leg, and was diagnosed as having Parkinson's disease because of akinesia. [ncbi.nlm.nih.gov]

This progressive form begins with weakness, often in the hands and less frequently in the feet or mouth and throat. [merckmanuals.com]

[…] or hands. [medbroadcast.com]

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Cerebral Palsy with Spastic Diplegia

[…] reflexes Abnormal gait Crossed knees Walking on tiptoes Quick links [cerebralpalsy.org.uk]

becoming physically exhausted even when you internally know that you have more energy than you are able to use), contractures, spasms, and progressively worse deformities [en.wikipedia.org]

A clinical examination involving ‘hands on’ feeling for stiffness when moving a limb, measurement of range of movement of the joints, as well as strength, and A functional [cerebralpalsy.org.au]

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Paramyotonia Congenita

The first child presented with abnormal gait with difficulty to initiate movement. The second child had stiffness and gait abnormality precipitated by cold weather. [hkjpaed.org]

[…] with progressive cooling. [symptoma.com]

From the age of 3, he presented hands stiffness in cold circumstances, and the symptom would relieve in 10 h after keeping his hands in a warm environment. [tandfonline.com]

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Mucopolysaccharidosis Type 1

Hypermobile joints and an abnormal gait with a tendency to fall may also be presenting features. [genedx.com]

Progressive upper airway disease leads to obstructive sleep apnoea. [patient.info]

[…] a “claw hand deformity” Stiffness of the hips Knocked knees also known as “valgus deformity” Curvature of the spine also known as scoliosis Carpal tunnel syndrome (pinching [rarediseases.org]

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Schwartz-Jampel Syndrome

[…] disturbance Abnormal gait Abnormal walk Impaired gait [ more ] 0001288 Genu valgum Knock knees 0002857 Hip dysplasia 0001385 Hypertonia 0001276 Intellectual disability Mental [rarediseases.info.nih.gov]

[…] cartilages, joint contractures, blepharophimosis, unusual pinnae, myopia, pigeon breast, and progressive stiffness of the face and limbs (14–16). [spandidos-publications.com]

At the age of 6 years, these symptoms aggravated remarkably with generalized muscle stiffness, difficulty in releasing his hand grip from objects he holds, has to open the [amhsjournal.org]

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Ankylosing Spondylitis

Sawacha Z, Guarneri G, Cristoferi G, Guiotto A, Avogaro A, Cobelli C (2009) Diabetic gait and posture abnormalities: a biomechanical investigation through three dimensional [doi.org]

These deformities are excessive dorsal kyphosis with compensatory cervical lordosis and hip flexion contracture. [physio-pedia.com]

shoulders and knees, morning stiffness lasting longer than 30 min and global pain measured as about 70 in the visual analogue scale (VAS 0–100). [doi.org]

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Multiple Sclerosis

abnormalities (e.g. wide-based gait, limb ataxia, slapping foot) joint or muscle contractures neurological examination muscle spasticity increased deep tendon reflexes muscle [orthobullets.com]

contractures of the metacarpophalangeal, proximal, and distal joints; radial deviation of the wrists; and corneal clouding since the age of 5 years. [pediatrics.aappublications.org]

which may become stiff Problems with vision Vision may become dim or blurred. [merckmanuals.com]

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Juvenile Idiopathic Arthritis

Leg length discrepancy from asymmetric knee synovitis and bone growth may cause flexion contractures, gait abnormalities and long-term growth abnormalities. 15. [slideshare.net]

Your healthcare provider may recommend one or more of the following treatments: Medications to reduce inflammation, relieve pain and slow the progression of the disease Splints [childrens.com]

But if I accidentally eat anything with eggs or dairy in it, the very next day my hands are stiff and sore. [drmcdougall.com]

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Pseudo-Hurler Polydystrophy

Progressive degeneration of the hip and joint contractures may cause difficulty walking or force affected individuals to walk with a characteristic waddling gait. [rarediseases.org]

[…] of the hands. [ncbi.nlm.nih.gov]

A progressive destruction of the hip joints represents one of the most disabling features of this disease, often leading to a characteristic waddling gait. [themedicalbiochemistrypage.org]

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Muscular Dystrophy-Dystroglycanopathy Type C5

These symptoms have progressed to affect his gait, now walks with an abnormal gait (waddlimg) associated with lower back pain. [chs-journal.com]

– not usually very rapidly progressive – joint contractures may be present 2B dysferlin 15-25 usually (variable) no no – usually slow progression – muscle pain and swelling [mda.org.au]

[…] of distal muscles of the body such as those controlling the hands and feet. [mda.org]

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Mucopolysaccharidosis Type 6

MPS IVA patients with abnormal gait, total (000s) Table 16. MPS IVA patients with genu valgum, total (000s) Table 17. [giikorea.co.kr]

contractures of the metacarpophalangeal, proximal, and distal joints; radial deviation of the wrists; and corneal clouding since the age of 5 years. [pediatrics.aappublications.org]

Short and often claw-like hands, progressive joint stiffness, and carpal tunnel syndrome can restrict hand mobility and function. [en.wikipedia.org]

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Myotonic Dystrophy

A child with Duchenne MD may: have difficulty walking, running or jumping have difficulty standing up learn to speak later than usual be unable to climb the stairs without [nhs.uk]

Shortening of muscles or tendons around joints (contractures). Contractures can further limit mobility. Breathing problems. [mayoclinic.org]

hand to release it, but if both hands are stiff she just has to wait. [dailymail.co.uk]

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Adult Polyglucosan Body Disease

Progressive spasticity and weakness are also present due to upper and lower motor neuron involvement and patients have difficulty walking. [orpha.net]

(40%): Shoulders; Hips; Knees; Neck Weight loss Smooth muscle: Urinary or Fecal incontinence Hearing loss Course Progressive Disability related to disease duration 14 Disability [neuromuscular.wustl.edu]

The APBDRF website describes a typical case: “In my early 50’s, I first experienced numbness in my hands, cramps, stiffness and heaviness in my legs. [blogs.plos.org]

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Mucopolysaccharidosis Type 4

Hypermobile joints and an abnormal gait with a tendency to fall may also be presenting features. [genedx.com]

Progressive upper airway disease leads to obstructive sleep apnoea. [patient.info]

Joint stiffness, restricted mobility. Phalangeal dysostosis which present as claw hand deformity. Eyes : Corneal clouding which can cause significant visual impairment. [genetics4medics.com]

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Mucopolysaccharidosis Type 4A

Treatment is based on the signs and symptoms present in each person. 0002750 Gait disturbance Abnormal gait Abnormal walk Impaired gait [2] Last updated: 7/24/2017 Mucopolysaccharidosis [rarediseases.info.nih.gov]

recurrent ear infections and progressive hearing loss. [touchophthalmology.com]

Short and often claw-like hands, progressive joint stiffness, and carpal tunnel syndrome can restrict hand mobility and function. [en.wikipedia.org]

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Hereditary Spastic Paraplegia

HSP is a heterogeneous group of neurodegenerative disorders with progressive lower limb spasticity and weakness leading to abnormal gait as the principal clinical feature. [omicsonline.org]

Although HSP is a progressive condition, the prognosis for individuals with HSP varies greatly. [en.wikipedia.org]

Most forms of HSP mainly affect the lower body – the arms and hands are usually unaffected. [your.md]

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