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Finger pain


A painful finger is a common presenting symptom. This may vary from an obvious local lesion to part of a generalised disease, e.g. rheumatoid arthritis. Impairment of the function of even a single finger may grossly impair the overall function of the hand.

Causes

Traumatic

  • ●

    Subungual haematoma

  • ●

    Fractures

Inflammatory/infective

  • ●

    Paronychia

  • ●

    Pulp space infection

  • ●

    Tendon sheath infection – especially if open

Neoplastic

  • ●

    Glomus tumour

  • ●

    Bone tumour

Degenerative

  • ●

    Rheumatoid arthritis

Vascular

  • ●

    Chilblains

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    Small vessel disease

    • ●

      Raynaud’s phenomenon ( Fig. 22 )

      Figure 22, Raynaud’s phenomenon .

    • ●

      Buerger’s disease

    • ●

      Emboli

Metabolic

  • ●

    Gout

Autoimmune

  • ●

    Scleroderma

Neurological

  • ●

    Carpal tunnel syndrome

  • ●

    Cervical lesions

History

Traumatic

There will be a history of trauma, often a crushing injury. Subungual haematoma results from ‘trapping’ of the nail. It is extremely painful, as a bruise comes up between the nail and the nailbed.

Inflammatory/infective

Paronychia

This presents as a painful, tender spot close to the nail. It throbs and may keep the patient awake. There may be a history of picking the skin around the nail. Pus may exude from the side of the nail.

Pulp space infection

This occurs in the pulp space of the fingertip. There may be a history of penetrating injury, e.g. a prick with a sharp object. There is pain, redness and swelling, and the finger throbs.

Tendon sheath infection

There may be a history of a direct puncture wound, or there may be a preceding pulp space infection, which has extended into a tendon sheath. The patient presents with a red, swollen and painful finger held in slight flexion at the IP and MCP joint.

Neoplastic

Glomus tumour

This is a rare lesion. The patient complains of severe pain every time the nail is touched, the most common site being below the nail.

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