Painful left index finger in a 37-year-old man

Abstract

A 37-year-old man presented with a 7-year history of severe paroxysmal pain in the left index finger. The symptoms were worse in winter and were triggered by trauma and contact with cold water. He was otherwise healthy.On examination, he had a tender lesion, 6 · 4 mm in size, on the lateral aspect of the distal phalanx of the left index finger. The overlying skin seemed normal (Fig. 1a). A radiograph of the affected finger showed a soft-tissue lesion eroding the adjacent bone (Fig. 1b). A globular, encapsulated, greyish white lesion was completely excised under local anaesthesia (Fig. 1c), and the symptoms subsided after surgery.