These are small  benign swellings, located on the back of the last articulation of the fingers (distal inter-phalangeal joint) near the nail. These are cysts of articular origin, filled with a translucent, viscous fluid. They often develop on osteoarthritic joints. The tendency of these cysts is to extend, either at the depth where they compress and deform the nail, or in area where they are fistulized.

Alai SMC


The tumefaction, located on the dorsal surface of the finger just upstream of the nail, is the main sign. The skin can be very fine, almost transparent. The nail is sometimes deformed longitudinally, mostly recessed, over the entire length. The underlying IPD joint is most often osteoarthritis, causing pain, joint deformation and limitation of mobility. Finger radiography is necessary to find underlying osteoarthritis


Aspiration of the contents are useless, as recidivism is the rule. Bulky cysts, fistulized, or complicated by nail deformity should be operated. When the skin is fragile or pierced, it is removed to be covered by a skin graft (taken from the hand or forearm) or a flap (the neighboring skin is peeled off and turned over the loss of substance). It is also necessary to remove the bone protrusions from the joint (parrot beaks). Nothing is done on the deformed nail: after the removal of the cyst, the nail regrowth will often make the deformation disappear. If the joint is deformed and painful, a blockage of the IPD joint (arthrodesis) can be achieved.

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