I banged my middle thumb knuckle into a metal shelf at work it instantly hhad a bump and pain after a few days it was fine then a few weekslater I hit it again now the bump won't go away and when I slightly brush it against something it wil hurt like the dickens if I porpusly press on it it doesn't hurt and sometimes ill bang it on something and I wanna scream it hurts so much. I'm not clumsey I just have a very fast paced job where I use my hands around a lot of metal shelving. Thak you for any insight and help
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replied November 29th, 2011
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Unfortunately, the fingers do not take a joke very well. It really does not take a lot to injure them. However, without an examination and some x-rays, it is not possible to determine exactly what is going on.

It sounds like you have some inflammation going on in the joint. This can cause swelling, decreased range of motion, and discomfort. Sometimes, when there is excess fluid in the joint, a mucus cyst will form around the joints of the fingers. A mucus cyst is just another name for a ganglion cyst. This can vary in size from tiny little bubbles to fairly large cysts. They can also feel very firm.

Most other nodules come from systemic disorders. Osteoarthritis commonly forms bumps on the distal joints, called Hebereden nodes. Rheumatoid arthritis (RA) is also known to form nodules. Gout can also cause tophi, or bumps filled with uric acid crystals.

But, yours showed up after trauma.

It is possible, with significant trauma, to actually knock a tiny piece of bone or cartilage off the edge of a joint. The body will then wall this piece off, forming a lump. The only way to know if this has occurred, would be to x-ray the joint.

So, if the lump does not go away shortly and continues to bother you, you might consider seeing a hand surgeon. If you go to a general practioner, you will most likely get the diagnosis of "arthritis" and told to ice, elevate, and take some ibuprofen, which you have probably already done. So, it is usually better to just go straight to the hand surgeon in the first place. That way you will get a thorough evaluation right off the bat.

In the mean time, try to protect the area from further injury. When your thumb in sore, it truly does seem to stick out and get injured more easily. So, if you can, you might want to wear some gloves or, at least, cover the thumb with a little padding. Ice or heat if needed for discomfort. And if you can take it, some NSAIDs like ibuprofen will help with any swelling from inflammation. Some patients prefer to tape or strap the thumb when working to provide a little support.

Hope your thumb feels better soon. Good luck.
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