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observe the position of the hands in motion to see if movements are smooth and natural when fingers are relaxed they should be slightly flexed inspect the patients wrists and hands noting any swelling over the joints as well as any deformities or angulation observe the contours of the palm namely the thenar and hypothenar eminence --is note any thickening of the tendons or fingers palpate the distal radius and ulna on the lateral and medial surfaces of the wrist palpate the radial styloid bone and the anatomical snuffbox a hollow depression just distal to the radial styloid process pain when palpating the snuffbox suggests a scaphoid fracture palpate over the eight carpal bones lying distal to the wrist joint and then each metacarpal phalangeal joint compress the mCP joints by squeezing the hand from each side between the thumb and fingers note any tenderness swelling or bugginess now palpate the medial and lateral aspects of each of the proximal interphalangeal joints between the thu