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
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.
Neoplastic
Glomus tumour
This is a rare lesion but it is very painful. The patient complains of severe pain every time the nail is touched, the most common site being below the nail.
Primary and secondary bone tumours
These are rare in the phalanges. Pain and swelling occurs and there may be a history of a primary tumour, e.g. breast, bronchus, thyroid, kidney or prostate.
