Presentation
Trauma to the left middle finger a few weeks back. Now presents with swelling, pain and a draining sinus.
Patient Data
There is focal dorsal soft tissue swelling of the left middle finger centered at the DIP joint and proximal nail fold.
This appears more pronounced than the swelling of the index finger at the DIP joint.
There is DIP osteoarthritis with joint space narrowing, bone remodeling and osteophyte formation especially of the index and middle fingers and the interphalangeal articulation of the thumb.
PIP and MCP joint spaces are narrowed too.
There is age-appropriate osteopenia and calcified plaque of the left radial artery.
Case Discussion
A case of typical age-appropriate DIP osteoarthritis with Heberden nodes especially affecting the index and middle fingers.
Heberden nodes are a clinical examination sign related to the hands, most commonly found at the dorsolateral aspect of the distal interphalangeal joint (DIPJ) and are a moderate-to-strong marker of osteoarthritis
Supra-added paronychia of the left middle finger accentuates the soft tissues of the proximal nail fold.
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