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| IMAGE QUIZ ARCHIVE | ||||||
| Image Quiz | ||
| Persistent Pain in the Ring Finger | ||
| By S. Raja, MB, MS(Orth), FRCS, K. Chirputkar, MB, MS(Orth), FRCS, and M.S. Srinivasan, MB, MS(Orth), MCh(Orth), FRCS(Orth), Department of Orthopaedics, Blackburn Royal Infirmary, Blackburn, United Kingdom | ||
| A thirty-year-old woman presented with intermittent pain, of five months duration, in her nondominant ring finger. The pain radiated throughout the palm and the forearm and was severe during activity and in cold weather. There was no history of trauma to the finger and no history of sensory or motor disturbances in the ipsilateral upper extremity or in the cervical spine. | ||
| Clinical examination revealed normal findings with no tenderness or changes in the nail of the ring finger. Provocative tests for carpal tunnel syndrome and cubital tunnel syndrome were negative. Neurological examination of the upper limb revealed normal findings. | ||
| Four months after presentation, the symptoms worsened. The nail of the ring finger had purplish discoloration that measured 3 mm in diameter, with marked tenderness of the lesion upon palpitation. No deformity of the nail was noted. | ||
| An excision biopsy was performed through a transungual approach with the patient under ring block anesthesia. | ||
| For larger view, click on image | ||
 Fig. 1 |  Fig. 2  Fig. 3 | |
| What is the diagnosis? | ||
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