A patient with chronic fingertip pain
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A 41-year-old right-hand dominant female presented to the hand surgery clinic with a 4-year history of fingertip pain affecting her right index finger, which significantly impaired hand function. She had an unremarkable past medical history and works as an administrator. On examination, there were no visible deformities with a preserved range of motion throughout the distal and proximal interphalangeal joints as well as the metacarpal phalangeal joints. On closer inspection, there was a violaceous hue noted on the nail plate. Fingertip pain was intensified following application of pressure via a pinhead and the patient reported a reduction in pain following the application of a digital tourniquet.

A radiograph of the affected digit demonstrated no bony abnormalities. Ultrasonography of the distal phalanx demonstrated a discrete mass measuring 0.4 by 0.6 cm on the dorsal aspect of the distal phalanx and a glomus tumor was subsequently diagnosed. The patient underwent excision of the glomus tumour by raising an eponychial flap and removing the tumour through a transungal approach. Surgical excision provided complete pain relief and subsequent significant improvement in perceived hand function.

Source:https://academic.oup.com/jscr/article/2020/11/rjaa477/6009327
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