Lumps and Swelling

Common soft tissue tumour of the hand and wrist are ganglion and giant cell tumour of the tendon sheath. Others include gloms tumour, nerve tumour, epidermoid inclusion cyst, foreign body granuloma, vascular tumour and malformation and tendon fibroma.
Most of these tumours are benign and non cancerous. Some are painless while others may have variable degree of pain i.e. constant pain, pain only on contact. Nerve tumour or any tumour that compresses the adjacent nerve may cause numbness.

Bone tumours of the hand are not uncommon. Mostly, they are benign and non-cancerous. You can present with pain and when the tumour is big, you may notice a swelling of the finger or hand. The adjacent joint movement can be limited by the swelling of pain. Occasionally, the tumour may weaken the bone structure resulting in fracture following a minor trauma.

Cancer of the skin is not uncommon. These abnormal malignant cells can invade through the skin into adjacent structures or travel throughout your body and become implanted in other organs and continue to grow, a process called metastasis. Squamous cell carcinoma is the most common type of skin cancer of the hand, followed by basal cell carcinoma and melanoma. Other rare cancers of the skin are Kaposi’s sarcoma, dermato-fibrosarcoma protuberans, sweat gland tumors, and Merkel cell carcinoma, to name a few.

Hand arthritis is a common condition. In majority, it is due to degenerative changes to the joint cartilage and “wear and tear” process (primary osteoarthritis). Sometimes the joint can be injured from previous trauma or fracture (traumatic osteoarthritis) . You can experience stiffness of the affected joints. These joints can be painful. Swelling and lumps can appear at the joint from the increased joint fluid (effusion) or from the bone spurs along the margin of the joint. In severe cases, the fingers and wrist can be deformed and some of the hand functions can be impaired.
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Rheumatoid arthritis is another form of arthritis that can affect multiple small joints of the hands and feet in relatively younger patients. Patients with rheumatoid arthritis often wake up with stiff and swollen joints of the hands. Often, the joints feel hot and look red. In late cases, the joints can be destroyed, dislocated and deformed. The affected finger can be crooked and bent awkwardly.
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Trigger finger is a common hand condition. It is also known as stenosing tenosynovitis. When it occurs in the thumb it is called “trigger thumb.” The tendons that bend the fingers glide easily with the help of pulleys that form a tunnel for the passage of the tendons. These pulleys hold the tendons close to the bone. Trigger finger occurs when the pulley becomes too thick at its opening, so the tendon cannot glide easily through it. You will experience “triggering” as the finger is straightened from a bent position. This may be accompanied with a sudden sharp pain at the base of the finger. In severe cases, the finger cannot be straightened further as the tendons fail to glide at all.

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Dupuytren’s contracture is an abnormal thickening of the fascia tissue just beneath the skin. This thickening occurs in the palm and can extend into the fingers. Pits, firm bumps and cords can develop and cause the fingers to bend into the palm. Occasionally, the disease will cause thickening on top of the knuckles or cause lumps and cords on the soles of the feet (plantar fibromatosis). Some of this thickening can also be found on the penis.
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Gout and pseudogout are two types of arthritis that can cause sore joints. In these two conditions, crystals form in the joint and in the tendons near the joint, causing irritation. Joints can become swollen, painful, and red. These conditions can affect joints all over the body. In gout, the first joint affected is often the big toe. The elbow, wrist, and finger joints are also common sites. In pseudogout, larger joints such as the knee or wrist are more commonly involved. These painful attacks can come and go in the same joint or in different joints. Deposition of crystals outside the joint is known as tophus and this can enlarged if untreated damaging joints and tendons as well as compressing nerves causing numbness and weakness.