General Practitioners

• Arthritis
  Arthritis means an inflamed joint. A joint normally consists of two cartilage-covered bone surfaces that glide smoothly against one another. When joints become inflamed, the joint swells and does not move smoothly. Over time, the gliding surface wears out. There are many types of arthritis. Rheumatoid arthritis is just one type. Wear and tear arthritis (osteoarthritis), gouty arthritis, and psoriatic arthritis are three other common types. Rheumatoid Arthritis is considered a systemic disease. That is, it can affect many parts of the body. Patients often awaken with stiff and swollen joints. Early on, many patients feel tired. Two thirds of patients with rheumatoid arthritis have wrist and hand problems.
• Primary Care
  A referral from another physician is not required to come to this office; however, your insurance may require a referral from a primary care physician. This would need to be taken care of by your primary care physician before calling to make an appointment with our specialists. If you cannot keep your appointment for any reason, please call to cancel so that we can give this time to another patient.
• Emergency Care
  We always prefer to handle routine problems during office hours. However, we know that urgent situations arise, and as a service to you we make ourselves available after normal working hours. If an emergent situation arises after office hours, call our answering service at (864) 585-4263. A physician is always on call to respond to your urgent medical problem. In case of a life threatening emergency, go directly to the nearest hospital emergency room.
• Pneumonia

Gynecologists

• Pregnancy

Neurologists

• Carpal Tunnel Syndrome
  Carpal tunnel syndrome symptoms usually include pain, numbness, tingling, or a combination of the three. The numbness or tingling most often takes place in the thumb, index, middle, and ring fingers. The symptoms usually are felt during the night but also may be noticed during daily activities such as driving or reading a newspaper. Patients may sometimes notice a weaker grip, occasional clumsiness, and a tendency to drop things. In severe cases, sensation may be permanently lost and the muscles at the base of the thumb slowly shrink (thenar atrophy), causing difficulty with pinch.

Endocrinologist

• Diabetes Care
• Hypothyroidism
  In gout, crystals develop when patients over-produce or under-excrete uric acid. Certain medications can cause rapid changes in uric acid level. These include certain blood pressure medications, diuretics, intravenous blood thinners, and a medication used for transplant patients called cyclosporin. Alcohol also increases uric acid production. Hypothyroidism, heart disease, and kidney disease have also been shown to be associated with gout. Attacks of gout have been noted after injury, surgery, infection, and the use of contrast materials for x-rays.
• Thyroid

Radiologist

• Ultrasound
  Physical Therapy – may be helpful, providing stretching and/or strengthening exercises. Modalities such as ultrasound or heat treatments may be helpful.
• MRI
  A careful history and physical exam performed by a hand surgeon can help to determine the type of hand or wrist tumor. X-rays might be taken to evaluate the bones, joints, and possibly the soft tissue. Further studies such as CT, MRI, or bone scan may be done to help narrow down the diagnosis. Recommendations for treatment are based on the experience of the hand surgeon and preferences of the patient.
• X-Rays
• Computed Tomography
  The lymph nodes should also be examined as they are a common site for metastasis, especially for melanoma and squamous cell carcinoma. Other evaluations, such as sentinel lymph node biopsy, CT scan, and/or PET scan may be needed to check for metastasis, especially with melanoma.
• Chemotherapy
  The standard therapy is surgical removal of the cancer with appropriate margins that are free of cancer cells at the edge of the excised tissue. Additional interventions such as skin grafting, tissue flap coverage, local amputation, radiation, and/or chemotherapy may also be needed.

Surgeons

• Orthopedics
  Good hand function is basic to the activities of daily life. We all take this essential function for granted until injury or disabling pain causes us to miss these activities! This specialized practice of orthopedics is dedicated to providing comprehensive care and treatment of injuries and disorders of the bones, joints, muscles, ligaments, tendons, and other soft tissues of the hands and upper extremities for patients of all ages.
• Arthroscopy
  Surgery is only considered when the pain is incapacitating and has not responded to conservative care, and symptoms have lasted more than six months. Surgery involves removing the diseased, degenerated tendon tissue. Two surgical approaches are available; traditional open surgery (incision), and arthroscopy—a procedure performed with instruments inserted into the joint through small incisions. Both options are performed in the outpatient setting.
• Pinched Nerve
  Carpal tunnel syndrome (CTS) is a condition brought on by increased pressure on the median nerve at the wrist. In effect, it is a pinched nerve at the wrist. Symptoms may include numbness, tingling, and pain in the arm, hand, and fingers. There is a space in the wrist called the carpal tunnel where the median nerve and nine tendons pass from the forearm into the hand (see Figure 1). Carpal tunnel syndrome happens when pressure builds up from swelling in this tunnel and puts pressure on the nerve. When the pressure from the swelling becomes great enough to disturb the way the nerve works, numbness, tingling, and pain may be felt in the hand and fingers (see Figure 2).
• Hand Surgery
  Tendon transfer surgery is a type of hand surgery that is performed in order to improve lost hand function. A functioning tendon is shifted from its original attachment to a new one to restore the action that has been lost.
• Arthroscopy

Dermatologists

• Skin Cancer
  Skin cancer is a change in some of the cells of your skin such that they grow abnormally to form a malignant tumor. These abnormal cells can invade through the skin into adjacent structures or travel throughout your body and become implanted in other organs and continue to grow, a process called metastasis. The skin is the most common part of the body in which cancer develops. In the hand, squamous cell carcinoma is the most common type of skin cancer, followed by basal cell carcinoma and melanoma. There are other, more rare forms of skin cancer, such as Kaposi’s sarcoma, dermato-fibrosarcoma protuberans, sweat gland tumors, and Merkel cell carcinoma, to name a few.
• Cyst
• Fungus
  A paronychia is an infection of the cuticle area around the fingernail (see Figure 2). Acute paronychia is caused by bacteria, and presents with redness, swelling, pain, and later with pus. Early cases may be treated with soaks and antibiotics, but if pus is seen or suspected, drainage by lifting the cuticle and/or nail, or lancing the area, is required also. Chronic paronychia is caused by fungus, and the cuticle area becomes just mildly red and swollen, with scant or no drainage and mild tenderness. It occurs in people whose hands are frequently wet, such as bartenders. It may be treated with special medication and reduction or elimination of the constant exposure to moisture, which promotes this fungal infection. On occasion, surgery is needed to remove infected tissue. It is commonly mistaken for a bacterial infection. Prolonged treatment is common with chronic paronychia. Acrylic nails are known to harbor a variety of bacteria and can aggravate a nail bed infection.
• Lesions
  Squamous cell carcinoma, basal cell carcinoma, and melanoma are all associated with chronic sun exposure, light or fair complexion, and immune suppression. Other factors include radiation exposure, exposure to certain chemicals, such as arsenic, and certain genetic conditions, such as xeroderma pigmentosum and Gorlin syndrome. Pre-malignant lesions, such as actinic keratosis, cutaneous horns, and Bowen’s disease, may develop into squamous cell carcinoma. Family history and certain types of nevi (moles) may also indicate a predisposition to melanoma.
• Burns

Physical Therapists

• Physical Therapy
  Recovery from surgery includes physical therapy to regain motion of the arm. A strengthening program will be necessary in order to return to prior activities. Recovery can be expected to take 4–6 months.
• Occupational Therapy
  Brittany earned her Masters of Occupational Therapy degree from Saint Ambrose University in Davenport, IA in 2011 and her certification in Hand Therapy in 2017.
• Tennis Elbow
  Lateral epicondylitis, commonly known as tennis elbow, is a painful condition involving the tendons that attach to the bone on the outside (lateral) part of the elbow. Tendons anchor the muscle to bone. The muscle involved in this condition, the extensor carpi radialis brevis, helps to extend and stabilize the wrist (see Figure 1). With lateral epicondylitis, there is degeneration of the tendon’s attachment, weakening the anchor site and placing greater stress on the area. This can then lead to pain associated with activities in which this muscle is active, such as lifting, gripping, and/or grasping. Sports such as tennis are commonly associated with this, but the problem can occur with many different types of activities, athletic and otherwise.