What is the significance of examination of the hands in anaemia ?

Examination of hand is an important part of anemia evaluation because of the following

1. Paleness of nail beds and palm helps to detect the presence of anaemia.
2. Koilonychia or spooning of nail bed if present gives a clue to the type of anaemia, such as iron deficiency anaemia.
3. In severe anaemia, You may get capillary pulsation.
4. Presence of splinter haemorrhage or Osiers node indicates SBE.
5. Anaemia with finger deformities may be seen in rheumatoid arthritis.
6. Colour of palmar creases gives a clue lo the severity of anaemia. 

When they arc is as pale as the surrounding skin, usually has a haemoglobin level < 7 g/dl.

In ophthalmoscopic examination if the retina seems very pale, the haemoglobin concentration is usually < 4 g/dl.