Knuckle pads: an ancient disease frequently misdiagnosed because of minimal modern attention

A case of knuckle pad syndrome in a middle‐aged man

“…Due to the appearance of the lesions and close association with joints such as the PIP, it may be clinically difficult to distinguish knuckle pads from other entities such as synovitis, rheumatoid nodules, Heberden nodes, or even gouty arthropathy. Knuckle pads may also be difficult to distinguish from other dermatologic diagnoses such as erythema elevatum diutinum, verruca, granuloma annulare, and pachydermodactyly 13–16 . Patients are often referred to rheumatologists for evaluation and undergo evaluation for rheumatologic disease such as in the case of our patient.…”

“…Knuckle pads may also be difficult to distinguish from other dermatologic diagnoses such as erythema elevatum diutinum, verruca, granuloma annulare, and pachydermodactyly. 13 , 14 , 15 , 16 Patients are often referred to rheumatologists for evaluation and undergo evaluation for rheumatologic disease such as in the case of our patient. Distinguishing knuckle pads from synovitis may be challenging on the basis of physical examination alone.…”

A Case of Knuckle Pad Syndrome in a Middle-Aged Man

“…Due to the appearance of the lesions and close association with joints such as the PIP, it may be clinically difficult to distinguish knuckle pads from other entities such as synovitis, rheumatoid nodules, Heberden nodes, or even gouty arthropathy. Knuckle pads may also be difficult to distinguish from other dermatologic diagnoses such as erythema elevatum diutinum, verruca, granuloma annulare, and pachydermodactyly [13][14][15][16]. Patients are often referred to rheumatologists for evaluation and undergo evaluation for rheumatologic disease such as is in the case of our patient.…”