What would cause the knuckle at the base of the right index finger to
be enlarged?  The appearance is rather like that of a beginning bunion
except it is on the hand rather than the foot.  There is a small
amount of soreness.  What could cause this?  Could this be caused
through frequent clicking of a computer mouse?

Dear alexandraroman, 

Thank you for submitting your question to Google Answers!

The symptoms you described, on the knuckle of the right index finger,
could most certainly be caused by an RSI, or repetitive strain injury.
RSI’s are medical conditions brought about by sustained, repeated
activity such as swinging a tennis racket or clicking a mouse.

Swelling on just the index finger, associated with soreness and/or
heat, tingling sensations is probably either tendonitis or bursitis.
Tendonitis is a swelling of the tendons, which are basically the
strings your muscles use to pull on your joints and move you around.
Bursitis is a more likely candidate, as it is associated with visible
swelling around the effected area.

Bursitis is a condition caused by inflammation of the bursa. Bursae
are basically little, oily sacks situated through the body to assist
in the movement and lubrication of joints. Repeated motions, constant
pressure, and or injuries can cause them to become inflamed, in which
case they will appear as a swolled lump on the skin.

RSI’s start out small, but have the potential to become crippling
injuries. The best course of action, when confronted with an RSI, is
to halt the activity you think is causing it as soon as possible.
Either that, or try to do it as infrequently as you can, until you can
get medical help. In this case, I would also suggest applying ice to
the effected area and elevating it if the swelling gets worse. I also
suggest seeing an orthopedic hand specialist as soon as possible.


Additional Information: 

The RSI Epidemic
http://www.commandcorp.com/cci/epidemic.html

“Bursitis,” by Johnathon Cluett M.D. About.com (March 2002)
://www.google.com/search?hl=en&q=bursitis

Sports Injuries: “Bursitis”, by Dr. Andrew Turtel
http://espn.go.com/trainingroom/s/1999/0901/13909.html

eMedicine Journal, Volume 2, Number 4 (April 9,2001)
http://www.emedicine.com/emerg/topic74.htm


Search Terms Used: 

“RSI index finger”
://www.google.com/search?hl=en&safe=off&q=rsi+index+finger

“bursitis”
://www.google.com/search?hl=en&safe=off&q=bursitis

I hope this helps. Good luck!

Regards, 

Lunarloki

---

Request for Answer Clarification by alexandraroman-ga on 11 May 2002 21:46 PDT

Thank you very much for your detailed answer to my question.  I have a
follow-up regarding what you refer to as "swelling".  I didn't use
that word because the area around the knuckle isn't really inflamed. 
Frankly, it looks, when I close my fist, as though the lower part of
the knuckle is sort of sticking out in the direction of my thumb.
That's why I mentioned bunions. It looks like bone. Almost like a
little extra knuckle to the lower left of the main knuckle if I am
looking down at my closed fist. Would this also fit bursitis? Promise
this is my only follow-up.  Thanks again.

---

Clarification of Answer by lunarloki-ga on 12 May 2002 12:58 PDT

Dear Alexandraroman, 

I’ve looked into this a little further and discovered an additional
item,

A swelling on the knuckle of the hand could, of course, be any number
of things, but, since you mentioned the soreness and the
mouse-clicking, I’m banking that it probably is an RSI of some sort.

It could be an early stage of bursitis in which the inflammation isn’t
too serious and is just a small lump and some soreness, yes.

Then again, the movement you described in your request for
clarification, makes it sound almost like a bone spur. A bone spur is
an abnormal growth of bone that can be caused by excessive movement in
a joint or injury. In the fingers, it’s most often caused by excessive
cracking of the knuckles, but could also be caused by repetitive
strain.

Bone spurs vary in their degree of seriousness. A bone spur on the
heel can interfere with many nerves and be very painful. I have a bone
spur on my shoulder, from practicing Karate, that never causes me any
pain whatsoever. Since you described at least some soreness, however,
I would say that it’s something you’d want to get looked at.

In any case, any kind of soreness in that area should be investigated,
especially if you use a computer frequently, and or engage in any
other activities which require the use of your hands, as such an
injury may have the potential to incapacitate you. Especially if you
feel any discomfort during or after computer use.


Additional Information

“Bone Spurs are a Thorny Problem”, by Amy Julian. Health Factor
(Spring 2002)
http://www.carefirst.dohealth.com/dohealth/member/SelfCareWellness/vitWellness.asp?wellID=1960


Search Terms Used: 

“repetitive strain injuries spur knuckle”
://www.google.com/search?hl=en&safe=off&q=repetitive+strain+injuries+spur+knuckle


Thanks again for using Google Answers! Please don’t hesitate to ask,
should you require further clarification! I’m happy to help!

Regards, 

Lunarloki

This person went to a great deal of trouble to answer my question. 
Many thanks to him/her & also to the person who left the comment.

http://www.meritcare.com/hwdb/showtopic.asp?module_abbrev=HWKB1&pd_hwid=aa3102&topic_name=Finger,%20Hand,%20and%20Wrist%20Problems%20(Noninjury)&sequence=1
 Has some interesting information you may be interested in. ** A
rubbery lump on the front or back of your wrist or at the base of your
finger may be a ganglion cyst. ** Have you considered and arthritic
lump? I think Heberden nodes is one type.  This site has a good
explanation and pictures of both ganglion cyst and Heberden nodes: 
http://www.ozarkortho.com/patiented/hands.htm  -- Best of luck to you

I had exactly the same thing about two weeks ago, when I cleverly
deleted all the files on my computer and spent a considerable amount
of time re-typing the parts what I (also - cleverly) hadn't backed up.

I decided it was a 'flexor tendon sheath cyst', which is a specific
type of ganglion cyst described at
http://www.eatonhand.com/hw/hw013.htm .

It went away by itself quite happily in a few days after my typing
spree abated.