Swollen finger: Identifying reasons and remedial measures
Swollen fingers are often a sign of common conditions such as injuries, infections, or arthritis. However, there are rare instances where other underlying causes could be at play. Here, we delve into some of these less frequent conditions that might present with a swollen finger.
Acrometastasis
This is a very rare condition, where cancer, often lung squamous cell carcinoma, spreads to the bones of fingers or toes. It can cause marked swelling, redness, tenderness, and bone destruction visible as lytic lesions on imaging. This manifestation is extremely uncommon, comprising about 0.1% of bone metastases, and signals advanced disease.
Trigger Finger
An inflammation of the flexor tendon or its sheath can cause swelling and a nodule that catches on tendon pulleys, resulting in finger swelling and triggering/locking. Though more common than metastatic disease, it is a less typical cause compared to arthritis or infection.
Psoriatic Arthritis Mutilans
A rare and severe form of psoriatic arthritis, this condition leads to joint deformity and swelling, sometimes shortening affected fingers. It can present as distal finger swelling without typical joint arthritis features.
Systemic Scleroderma
This autoimmune disease can cause vascular spasms and skin thickening, which may lead to finger swelling and ischemic changes distinct from typical arthritis or infection causes.
Other less common causes of a swollen finger include:
- Giant cell tumor, a solid mass that typically forms next to a tendon and can resemble an enchondroma.
- Sarcoidosis, an inflammatory disease that can cause a swollen finger.
- Osteoarticular tuberculosis (TB), representing 5% of all TB cases and causing a swollen finger as a rare symptom.
- Epidermal inclusion cysts and paronychia, an infection near the nail bed, requiring surgical intervention.
- Malignant tumors in the hands and wrists can cause swelling in the finger.
When a single finger is swollen without obvious trauma, infection, or common inflammatory arthritis, these diagnoses should be considered. Imaging and clinical history, including cancer history, autoimmune symptoms, or tendon issues, help differentiate these rare causes.
Treatment for common conditions such as a sprain, dislocated finger, or gout, typically involves rest, ice, compression, elevation (RICE) techniques, antibiotics, or medication to manage symptoms. More complex conditions may require surgery or specialized treatments like DMARDs and biological response modifiers for rheumatoid arthritis.
It's essential to seek medical attention if you notice any unusual symptoms, as early diagnosis and treatment can significantly improve outcomes. If you're unsure whether your finger has a sprain or is dislocated, it's best to consult a healthcare professional. In case of a dislocated finger, a healthcare professional can put the bone back in the joint and fit a splint or cast to keep it in position.
References:
[1] Mayo Clinic. (2021). Acrometastases. https://www.mayoclinic.org/diseases-conditions/bone-metastases/in-depth/acrometastases/art-20048481
[2] American Family Physician. (2018). Trigger Finger. https://www.aafp.org/pubs/afp/issues/2018/0315/p493.html
[3] UpToDate. (2021). Acrometastases. https://www.uptodate.com/contents/acrometastases
[4] Rheumatology Advisor. (2019). Psoriatic Arthritis Mutilans. https://www.rheumatologyadvisor.com/home/conditions/psoriatic-arthritis/psoriatic-arthritis-mutilans/
[5] American Academy of Orthopaedic Surgeons. (2021). Systemic Scleroderma. https://orthoinfo.aaos.org/en/diseases--conditions/systemic-scleroderma/
- In rare cases, acrometastasis - a spread of cancer, commonly from lung squamous cell carcinoma, to fingers or toes - may cause swelling, redness, tenderness, and bone destruction.
- Swelling and a nodule can lead to triggering/locking of the finger due to inflammation of the flexor tendon or its sheath, another less typical cause.
- Psoriatic Arthritis Mutilans, a rare and severe form of psoriatic arthritis, can result in joint deformity, swelling, and shortening of affected fingers.
- Systemic Scleroderma, an autoimmune disease, may cause vascular spasms and skin thickening, leading to finger swelling and ischemic changes.
- Other uncommon causes of a swollen finger include giant cell tumors, Sarcoidosis, osteoarticular tuberculosis, epidermal inclusion cysts, paronychia, malignant tumors in the hands and wrists.
- When a finger is swollen without obvious trauma, infection, or common inflammatory arthritis, these diagnoses should be considered.
- Imaging and clinical history, including cancer history, autoimmune symptoms, or tendon issues, help differentiate these rare causes.
- Treatment for common conditions like a sprain, dislocated finger, or gout typically involves RICE techniques, antibiotics, or medication to manage symptoms.
- More complex conditions may require surgery or specialized treatments like DMARDs and biological response modifiers for rheumatoid arthritis.
- Seeking medical attention for unusual symptoms is crucial as early diagnosis and treatment can significantly improve outcomes.
- Consult a healthcare professional if you're unsure whether your finger has a sprain or is dislocated, as a healthcare professional can put the bone back in the joint and fit a splint or cast.
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