Hand Therapist Nigel Chua Gout in the fingers arrives overnight, peaks in a day, and looks identical to a joint infection. It also has two separate treatments that people constantly confuse: one ends the attack, the other ends the disease.
The dog bite that looks terrible is usually the least dangerous. A cat’s puncture and a small split over a knuckle from someone’s tooth are the two that reach joints and tendons, seal bacteria in, and cost people fingers.
Numb hands on the bike are nerve compression at the wrist, and which fingers go numb tells you which nerve. The fix is usually load, position and padding. The deadline is numbness that no longer clears after you get off.
Deep pain in the heel of the palm after a golf, bat or racquet impact, with a normal X-ray. Standard wrist films miss this fracture routinely, and the untreated version sits on a nerve and saws at a tendon.
An audible pop on a crimp, pain at the base of the ring finger, and a decision about crimping that will shape the next six months. Grades, timelines, and the bowstringing sign that changes everything.
A soft, fluid swelling on the tip of the elbow that often barely hurts. Usually harmless and self-limiting. The one thing that has to be ruled out first is infection, and four signs separate them.
Flexor repairs fail loudly by rupturing. Extensor repairs fail quietly, as a lag: the finger bends fine and just stops straightening all the way. A few millimeters of tendon length become permanent degrees. Here’s the weekly check that catches it.
No Dupuytren’s treatment cures the disease. Needle release buys a fast recovery and a shorter reprieve; open surgery costs months and buys longer. And the joint that’s bent decides your result more than the operation does.
The scapholunate ligament tears in a fall, the X-ray looks normal, and it gets called a wrist sprain. Untreated it has a known ending: predictable wrist arthritis about a decade later. Six weeks buys a repair, six months a reconstruction, six years a fusion.
The ulnar nerve gets squeezed at the elbow and at the wrist, with near-identical symptoms. Check the back of your hand: normal there means the wrist. And unlike carpal or cubital tunnel, Guyon’s canal usually has a specific findable cause, often a cyst or a missed hamate fracture.