Seamstress's finger.

Abstract

Case 1 A 56 year old right handed woman was seen with a two to three year history of aching in her right index finger. She had no other symptoms, there was no history of trauma to her hands or medical history of note, and she was taking no medication. She had worked as a sewing machinist in the same factory for 28 years and did dress making in her spare time. She had a flexion deformity of the distal inter phalangeal joint of the right index finger. There were prominent Heberden's nodes on the index and middle fingers and thumb of the right hand. Smaller Heberden's nodes were present on the index finger and thumb of her left hand. There was a prominent callosity on the right middle finger due to repeated friction from metal scissors. There were no signs of joint hypermobility.2 x Ray films of her hands showed severe degenerative changes at the distal interphalangeal joint of the right index and middle fingers with loss of joint space, articular sclerosis, osteophytes, and bone cysts (figure). There was a particularly prominent dorsal osteo phyte from the proximal end of the distal phalynx of the right index finger (figure). She was negative for serum rheumatoid factor.