Striatal hand is characterized by flexion in metacarpopharyngeal (MCP) joints and hyperextension in proximal interphalangial (PIP) joints and flexion in distal interphalangeal (DIP) joint. In clinical practice, this problem is often overlooked or misdiagnosed as rheumatoid arthritis and the opportunity for an early diagnosis and a correct management of the patient's is missed. In this report, a case with striatal hand following traumatic brain injury (TBI) without cardinal Parkinsonian signs is presented, and the differential diagnosis of the disease is discussed. A-62-year-old man presented with hemiplegia subsequent to traumatic brain injury. During the last two years, "swan neck" deformity of the hands occurred. We could diagnose this case as striatial hand with exclusion of similar rheumatologic causes by careful study and its characteristic deformity pattern. Clinician should consider the possibility of striatal hand when the patient with TBI presents swan neck deformity for an early diagnosis and a correct management. (J Korean Acad Rehab Med 2008; 32: 345-348)
