The tip of my thumb hurts when I press it

If you feel any discomfort in your body, you should go to the hospital for a check-up in time. Although we can see skin diseases with the naked eye, some diseases inside the body cannot be observed with the naked eye. Pain will also occur during an attack, which will cause serious consequences over time. If you feel pain when you press the tip of your thumb lightly with your finger, it is likely to be a finger inflammation and you need to seek timely treatment.

Purulent dactylitis is a subcutaneous purulent infection on the palm surface of the distal phalanx of the finger, which is mostly caused by puncture wounds and the causative bacteria are mostly Staphylococcus aureus. Purulent dactylitis can form a pus cavity with very high pressure, which can not only cause severe pain, but also compress the nourishing blood vessels of the phalanges, causing ischemia and necrosis of the phalanges. If the pus directly invades the phalanges, it can cause osteomyelitis.

Causes

It is usually caused by worsening paronychia or secondary infection after injury to the skin of the fingertips or distal phalanges.

Clinical manifestations of purulent dactylitis

1. Initially, there is a pricking pain in the fingertips, followed by swelling of the tissues, increased pressure, and severe pain.

2. When the digital artery is compressed, the pain turns into throbbing pain, which worsens when the affected limb is hanging. The severe pain makes the patient irritable and unable to sleep all night.

3. Often accompanied by systemic symptoms such as fever.

4. In the later stage, some patients become paralyzed due to compression of nerve endings and nutritional disorders, and the pain in the fingers is relieved; the local skin turns from red to white, indicating that local necrosis may occur, which often leads to delayed wound healing.

Purulent dactylitis examination

1. Laboratory examination

Routine blood examination shows an increase in white blood cell count and neutrophil ratio, and pus can be collected to detect the type of pathogenic bacteria.

2. X-ray examination

Determine whether there is phalangeal necrosis. In severe cases, X-rays can show symptoms of osteomyelitis and dead bone formation in the distal phalanx.

Diagnosis of purulent dactylitis

1. There is often a history of finger puncture or crush injury.

2. The palm surface of the distal segment of the finger is swollen, with a "snake head" appearance, accompanied by severe throbbing pain, which worsens when the hand is hanging down; the palm side of the finger is red, swollen, hard and obviously tender, with no obvious local fluctuation.

3. In severe cases, X-rays may show symptoms of osteomyelitis and sequestrum formation in the distal phalanx.

4. Fingers appear pale when pressure is very high.

5. Accompanied by systemic symptoms such as fever and general malaise.

Treatment of purulent dactylitis

1. Raise the affected hand, brake it, and get enough rest. Physical therapy such as hot compresses or warm water baths can be used locally.

2. Give sedatives or analgesics.

3. Give antibiotic treatment, generally penicillin or other commonly used antibiotics.

4. Drainage or decompression should be performed as soon as possible.

5. After surgery, fix the patient in a functional position and suspend him/her with a sling.

6. After the infection is controlled, immediately start practicing automatic or passive movements to prevent ankylosis of the knuckles.