Skip to main content

Advertisement

SpringerLink
Log in

Ultrasound appearance of knuckle pads

  • Scientific Article
  • Published:
Skeletal Radiology Aims and scope Submit manuscript

Abstract

Objective

We describe the ultrasound appearance of knuckle pads.

Design and patients

Retrospective analysis of imaging in a series of five patients initially referred for evaluation of periarticular soft-tissue swelling of the hands involving the dorsum of the PIP and MP joints. Two patients had associated Dupuytren’s contractures. Ultrasound and radiographs of the hands in all patients were reviewed and correlated with clinical history and physical exams.

Results

Radiographs in four patients demonstrated dorsal soft-tissue thickening. Ultrasound exams showed increased dorsal subcutaneous thickening, with either diffuse or focal hypoechoic areas corresponding to the areas of soft-tissue fullness identified on physical exam. No erosions or synovial proliferation were identified either by radiographs or ultrasound of the underlying joints.

Conclusions

Knuckle pads can sometimes be difficult to distinguish from synovitis on physical examination. Musculoskeletal ultrasound can quickly identify these superficial lesions and exclude underlying synovial proliferation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Barnes C, Davies L. Knuckle pads. http://www.emedicine.com

  2. Guberman D, Lichtenstein DA, Vardy DA. Knuckle pads—a forgotten skin condition: report of a case and review of the literature. Cutis 1996;57:241–242

    PubMed  CAS  Google Scholar 

  3. Morginson WJ. Discrete keratoderma over the knuckle and finger articulation. Arch Derm 1955;71:349–353

    CAS  Google Scholar 

  4. Dickens R, Adams BB, Mutasim DF. Sports pads. Int Journ Derm 2002;41:291–293

    Article  Google Scholar 

  5. Allison JR JR, Alison Sr JR. Knuckle pads. Arch Derm 1966;93:311–316

    Article  PubMed  Google Scholar 

  6. Hueston JT, Wilson WF. Knuckle pads. Aust N Z J Surg 1973;42:275–277

    Google Scholar 

  7. Mikkelsen OA. Knuckle pads in Duputyren’s disease. Hand 1977;9:301–305

    Article  PubMed  CAS  Google Scholar 

  8. Caroli A, Zanasi S, Marcuzzi A et al. Epidemiological and structural findings supporting the fibromatous origin of dorsal knuckle pads. J Hand Surg [Br] 1991;16:258–262

    Article  CAS  Google Scholar 

  9. Karim Z, Wakefield RJ, Conaghan PG, Lawson CA, Goh E, Quinn MA et al. The impact of ultrasonography on diagnosis and management of patients with musculoskeletal conditions. Arthritis Rheum 2001;44:2932–2933

    Article  PubMed  CAS  Google Scholar 

  10. Lopez-Ben R, Bernereuter WK, Moreland LW, Alarcon GS. Ultrasound detection of bone erosions in rheumatoid arthritis: a comparison to routine radiographs of the hands and feet. Skeletal Rad 2004;33(2):80–84

    Article  Google Scholar 

  11. Scheel AK, Hermann KG, Kahler E, Pasewaldt D, Fritz J, Hamm B et al. A novel ultrasonographic synovitis scoring system suitable for analyzing finger joint inflammation in rheumatoid arthritis. Arthritis Rheum 2005;52:681–686

    Article  Google Scholar 

  12. Schmid-Wendtner MH, Burgdorf W. Ultrasound scanning in dermatology. Arch Dermatol 2005;141:217–224

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Diagnostic Radiology, The University of Alabama at Birmingham, UAB, N364 JT, 619 19th St S, Birmingham, AL, 35294-6830, USA

    Robert Lopez-Ben

  2. Division of Clinical Immunology and Rheumatology, Department of Medicine, The University of Alabama at Birmingham, Birmingham, AL, USA

    Keivan Dehghanpisheh, W. W. Chatham & Graciela S. Alarcón

  3. Department of Surgery, Division of Orthopedic Surgery, The University of Alabama at Birmingham, Birmingham, AL, USA

    Donald H. Lee & Jean Oakes

Authors
  1. Robert Lopez-Ben
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Keivan Dehghanpisheh
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. W. W. Chatham
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Donald H. Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jean Oakes
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Graciela S. Alarcón
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Robert Lopez-Ben.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lopez-Ben, R., Dehghanpisheh, K., Chatham, W.W. et al. Ultrasound appearance of knuckle pads. Skeletal Radiol 35, 823–827 (2006). https://doi.org/10.1007/s00256-006-0110-8

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00256-006-0110-8

Keywords

Search

Navigation