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FINGER
Nail Infections
Nail infections involve the invasion of the fingernails or toenails by bacteria, fungi, or other pathogens, leading to pain, discoloration, and changes in nail structure. Early detection and proper care are key to preventing complications.
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Definition: An infection of the nail bed, nail plate, or surrounding skin caused by fungi (common), bacteria, or yeast.
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Causes: Injury to the nail, excessive moisture, poor foot hygiene, tight shoes, or exposure to infected surfaces.
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Types of Nail Infections:
~ Fungal (Onychomycosis): Thickened, discolored, brittle nails
~ Bacterial (Paronychia): Redness, swelling, and pus near the nail fold
~ Yeast (Candida): Common in people with frequent water exposure
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Symptoms: Discoloration, thickening, brittleness, pain, swelling, foul odor, or separation of the nail from the bed.
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Diagnosis Tools: Clinical examination, nail scraping, fungal culture, or microscopy to identify the specific organism.
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Risk Factors: Diabetes, compromised immunity, nail trauma, poor hygiene, frequent wet work, and communal showers/pools.
Glomus Tumour
Glomus Tumour is a rare, benign growth from the glomus body, usually found under the fingernail. Though small, it causes severe pain and sensitivity, especially to cold.
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Definition: A non-cancerous tumor of the glomus body involved in temperature regulation, most commonly found under the nail.
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Causes: Often develops spontaneously; the exact cause is unknown.
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Types of Glomus Tumour:
~ Solitary Glomus Tumour: Most common, usually under the fingernail
~ Multiple Glomus Tumours (Glomangiomatosis): Less common, may be inherited
~ Extradigital Glomus Tumours: Occur outside of fingers/toes (e.g., forearm, shoulder)
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Symptoms: Sharp, localized pain, cold sensitivity, tenderness, bluish spot or nail deformity.
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Diagnosis Tools: Clinical tests (like Love’s test), MRI, ultrasound, confirmed by histopathology after removal.
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Risk Factors: More common in women, typically appears between ages 20–50.
Mucous Cyst
Mucous Cyst is a fluid-filled, non-cancerous lump that usually appears near the fingernail, often associated with joint degeneration or osteoarthritis.
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Definition: A small, benign, fluid-filled sac (ganglion) typically found near the distal finger joint, often over the nail.
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Causes: Linked to wear-and-tear changes in the joint (osteoarthritis), or leakage of joint fluid.
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Types of Fractures:
~ Digital Mucous Cyst: Commonly occurs on fingers, near nail bed
~ Non-digital Mucous Cyst: Less common, may appear in other mucous-secreting areas (e.g., lips)
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Symptoms: Smooth, round bump near the nail, may cause nail deformity, pressure, or mild pain.
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Diagnosis Tools: Physical exam, transillumination, and imaging (ultrasound or MRI) if needed.
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Risk Factors: Age (middle-aged to older adults), osteoarthritis, repeated joint stress.
Phalanx and Metacarpal Fractures & Dislocations
Phalanx and Metacarpal Fractures & Dislocations are common hand injuries caused by trauma, falls, or direct impact, affecting finger or hand bones.
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Definition: Breaks or dislocations in the finger (phalanges) or hand (metacarpals) bones.
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Causes: Falls, sports injuries, direct blows, or crush accidents.
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Types of Fractures:
~ Phalanx Fractures: Distal, middle, or proximal bones of the fingers
~ Metacarpal Fractures: Common in the neck (e.g., boxer’s fracture)
or shaft
~ Comminuted: Often at finger joints (PIP, DIP) or metacarpophalangeal joint
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Symptoms: Pain, swelling, bruising, deformity, limited motion, or finger misalignment.
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Diagnosis Tools: X-rays; CT for complex cases.
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Risk Factors: High-impact activities, falls, occupational hazards, weak bones.
Trigger Finger
Trigger Finger is a common hand condition where a finger or thumb gets stuck in a bent position and suddenly snaps straight, due to inflammation and narrowing of the tendon sheath.
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Definition: A condition where the flexor tendon catches or locks as it moves through the sheath, causing finger stiffness and snapping.
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Causes: Repetitive gripping, overuse, local trauma, or systemic conditions like diabetes and rheumatoid arthritis.
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Types of Fractures:
~ Mild: Occasional catching or stiffness
~ Moderate: Painful clicking or snapping
~ Severe: Finger locks in a bent position
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Symptoms: Pain or tenderness at the base of the finger/thumb, stiffness (especially in the morning), clicking, popping, or locking of the finger.
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Diagnosis Tools: Clinical examination is usually sufficient; imaging may be used to rule out other causes.
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Risk Factors: Age (40–60 years), diabetes, female gender, repetitive hand use, and inflammatory joint conditions.
Syndactyly And Polydactyly
These are congenital conditions affecting the fingers or toes. Syndactyly involves fused digits, while Polydactyly involves extra digits. Both may occur alone or as part of genetic syndromes.
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Definition: Syndactyly: Fusion of two or more digits by skin or bone.
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Definition: Polydactyly: Presence of extra fingers or toes.
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Causes: Mostly genetic—can be inherited or due to mutations. Sometimes linked to syndromes like Apert or Ellis–van Creveld.
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Types of Fractures:
~ Syndactyly: Simple (soft tissue) or Complex (bone); Complete or Incomplete
~ Polydactyly: Preaxial (thumb side), Postaxial (little finger side), Central (rare)
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Symptoms: Syndactyly: Webbing, reduced motion, possible deformity
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Symptoms: Polydactyly: Extra digit—functional, partial, or small and skin-attached only
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Diagnosis Tools: Physical exam and X-rays to assess bone involvement; prenatal ultrasound may detect it.
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Risk Factors: Family history, genetic syndromes
