Benign tumors of the hand may be categorized using the different anatomic subunits of the hand. Each subunit has potential for disease processes and abnormal growth. Notably, the musculoskeletal, vascular, osseous, perionychial, cutaneous, and soft tissue elements can develop benign lesions that may manifest as localized masses of the hand. Excluding cutaneous malignancy, 95% of tumors of the hand are benign. The nonneoplastic ganglion is probably the most common mass found on the hand and wrist. Some benign growths may not need excision (Athanasian, 1993). Following ganglions, inclusion cysts, warts, giant cell tumors, granulomas, and hemangiomas follow in frequency. This article outlines each of the subunits and discusses benign growths that may exist in each anatomic structure.
Synonyms and related keywords: benign hand tumors, vascular tumor, hemangioma, enchondroma, ganglion, hand tumor, hand mass, hand lesion, nonneoplastic ganglion, non-neoplastic ganglion, hand cyst, hand warts, warts, giant cell tumor, granuloma, hemangioma, benign growths, port wine stain, port-wine stain, nevus flammeus, Kasabach-Merritt syndrome, glomus tumor, Ollier disease, Ollier's disease, enchondromatosis, subperiosteal osteoid osteomas, osteoid osteomas, osteomas, schwannoma, neurilemmoma, fibrolipomatous hamartoma, hamartoma, neurofibroma, von Recklinghausen disease, von Recklinghausen's disease, neurofibromatosis, mucous cyst, mucus cyst, mucosal cyst, pseudosarcomatous fibromatosis, nodular fasciitis, pyogenic granuloma, nodular tenosynovitis, lipoma
Lin & Dumanian 2006

Felons are closed-space infections of the fingertip pulp.
Fingertip pulp is divided into numerous small compartments by vertical septa that stabilize the pad. Infection occurring within these compartments can lead to abscess formation, edema, and rapid development of increased pressure in a closed space. This increased pressure may compromise blood flow and lead to necrosis of the skin and pulp.
Synonyms and related keywords: closed-space infections, fingertip pulp, paronychias, hand infections, osteomyelitis, tenosynovitis, septic arthritis, Staphylococcus aureus, S aureus, Eikenella corrodens, E corrodens, wood splinter, minor cut, cellulitis, skin necrosis, felon, finger infection, fingertip infection
Author: Glen Vaughn, MD 2006

Major resource on hand and wrist conditions. Requires registration.

In 1939, Kanavel, author of the landmark Infections of the Hand, observed, "In almost all cases of serious infection the difficulty is to make a correct diagnosis both as to the nature of the infection and the position of the pus." Specific infections covered in this article include paronychia, felon, herpetic whitlow, tenosynovitis, and deep fascial space infections.
Synonyms and related keywords: hand infection, infections of the hand, paronychia, felon, herpetic whitlow, infectious tenosynovitis, deep fascial space infections, acute paronychia, hangnails, nail biting, manicuring, finger sucking, eponychia, artificial nails, chronic paronychia, metastatic cancer, subungual melanoma, squamous cell cancer, floating nail, subungual abscess, herpes simplex virus infection of the finger, HSV infection of the finger, HSV-1, HSV-2, dorsal subaponeurotic abscess, subfascial web space infection, midpalmar space infection, thenar space infection, Staphylococcus aureus, S aureus, Streptococcus species, Candida albicans, C albicans, atypical mycobacteria, Neisseriagonorrhoeae, N gonorrhoeae, Eikenella corrodens, E corrodens, Pasteurella multocida, P multocida, Capnocytophaga species, frank abscess, osteomyelitis
Authors: Rohini Jonnalagadda, MD & Gregory S Johnston, MD 2008

Hand infections can vary from routine problems (treated with oral antibiotics, immobilization, and limited incision and drainage)1 to catastrophic surgical emergencies (resulting in significant compromise of hand function). The purpose of this article is to provide a systematic approach to the diagnosis, evaluation, and treatment of hand infections.
Synonyms and related keywords: superficial infections, infections of the nail, paronychia, infections of the tendon and tendon sheath, tenosynovitis, infections of the deep spaces of the hand, septic arthritis, osteomyelitis, systemic lupus erythematosus, felon
Klein & Chang 2007

Most hand infections are bacterial and are the result of minor wounds that have been neglected. Human bite wounds are the second most common cause of hand infections. Hematogenous spread of infection from other sites to the hand is rare but can occur. A complete history and physical examination is necessary to exclude other associated medical conditions (eg, diabetes, arthritis, immunosuppression) that may compromise therapy. The history should ascertain the mechanism of injury, as this may provide some clues about the organism(s) most likely responsible for the infection. Radiographic evaluation may be indicated if the history and physical examination suggest a possibility of fracture, osteomyelitis, or foreign body.
Synonyms and related keywords: hand infections, herpetic whitlow, digital infection, paronychia, cellulitis, felon, bite wounds, web space infections, midpalmar space infection, pyogenic flexor tenosynovitis, septic arthritis, osteomyelitis, mycobacterial infections, viral infections, web space abscess, tenosynovitis, human bite, dog bite, cat bite
Author: Ramotsumi M Makhene, MD 2006

Herpetic whitlow is an intense painful infection of the hand involving 1 or more fingers that typically affects the terminal phalanx. Herpes simplex virus 1 (HSV-1) is the cause in approximately 60% of cases of herpetic whitlow, and herpes simplex virus 2 (HSV-2) is the cause in the remaining 40%.
Adamson first described herpetic whitlow in 1909, and in 1959, it was noted to be an occupational risk among health care workers.
As in other mucocutaneous herpetic infections, herpetic whitlow is initiated by viral inoculation of the host through exposure to infected body fluids via a break in the skin, most commonly a torn cuticle. The virus then invades the cells of the dermis and subcutaneous tissue, and clinical infection ensues within a matter of days.
Author: Michael S Omori, MD, 2007

Flexor tenosynovitis (FT) is a pathophysiologic state causing disruption of normal flexor tendon function in the hand. A variety of etiologies are responsible for this process. Most acute cases of FT are the result of infection. However, FT also can be secondary to acute or chronic inflammation as a result of diabetes, overuse, or arthritis. Much of the original work on infectious FT was done by Kanavel. If a patient presents with the 4 Kanavel signs, septic FT is diagnosed. The 4 Kanavel signs are (1) finger held in slight flexion, (2) fusiform swelling, (3) tenderness along the flexor tendon sheath, and (4) pain with passive extension of the digit. The process has the ability to rapidly destroy a finger's functional capacity and is considered an orthopedic emergency.
Synonyms and related keywords: acute flexor tenosynovitis, flexor tendon sheath infection, flexor tenosynovitis, pyogenic flexor tenosynovitis, suppurative flexor tenosynovitis, septic flexor tenosynovitis
Likes & Ghidella 2004

Osteoarthritis of the hand preferentially involves the distal interphalangeal (DIP) joint and the carpometacarpal (CMC) joint of the thumb.1 The proximal interphalangeal (PIP) joint is affected less commonly.
The term "osteoarthritis" has been used in the past to describe degenerative changes in the articular cartilage. However, a more descriptive term might be primary idiopathic osteoarthritis.
Synonyms and related keywords: osteoarthritis of the hand, erosive osteoarthritis, distal interphalangeal joint, DIP joint, carpometacarpal joint, CMC joint, primary idiopathic osteoarthritis, arthrodesis, arthroplasty
Author: Carlos A Garcia-Moral, MD 2008

A paronychia is a superficial infection of epithelium lateral to the nail plate. The acute painful purulent infection is most frequently caused by staphylococci. The patient's condition and discomfort are markedly improved by a simple drainage procedure.
A paronychial infection usually starts in the lateral nail fold. Occasionally, the infection includes the complete margin of skin around the nail plate. It results from mechanical separation of the nail plate from the perionychium. Early in the course of this disease process (<24 h), cellulitis alone may be present. An abscess can form if the infection does not resolve quickly.
Synonyms and related keywords: run-around, paronychial infection, onychia lateralis, onychia periungualis, inflammation of the nail fold, incision and drainage, I and D, I&D, paronychia, nail infection, superficial infection of the epithelium, staphylococci, infection of the hand, paronychia, finger infection
Murphy-Lavoie & Haydel 2006

Wrist pain often proves to be a challenging presenting complaint. Determining the cause of ulnar-sided wrist pain is difficult, largely because of the complexity of the anatomic and biomechanical properties of the ulnar wrist.1, 2 The objectives of this article are to provide an overview of the most common problems that are encountered in the diagnosis of ulnar-sided wrist pain and to review the anatomy, diagnostic modalities, clinical presentation, and various treatments available.
Synonyms and related keywords: triangular fibrocartilage complex injury, TFCC injury, distal radial ulnar joint arthritis, distal radioulnar joint arthritis, DRUJ arthritis, lunotriquetral instability, LT instability, triquetral fractures, carpal instability, palmar midcarpal instability, PMCI, Kienbock disease, Kienböck disease, Kienböck's disease, extensor carpi ulnaris tendon subluxation, ECU subluxation, extensor carpi ulnaris stenosing synovitis, ECU stenosing synovitis, ulnar styloid fractures, ulnar impaction syndrome, ulnar nerve compression, ulnar artery thrombosis, hamate fractures, hook fractures
Lichtman, Wroten & Joshi 2008