Article Text

Download PDFPDF
Spontaneous painful subungual thumb haematoma
  1. Nihull Jakharia-Shah1,
  2. Priyanka Chadha2,
  3. Mahendra Kulkarni3
  1. 1Department of Medicine, King’s College London, London, UK
  2. 2Department of Plastic Surgery, Chelsea and Westminster Hospital, London, UK
  3. 3Department of Plastic Surgery, Wexham Park Hosptial, London, UK
  1. Correspondence to Mr Nihull Jakharia-Shah, nihullshah{at}


We present the case of a 56-year-old man who presented to our accident and emergency department 15 years after a work-based injury to his left thumb.

In January 2017, the patient was woken up acutely with excruciating pain in his left thumb with no preceding trauma. On clinical examination, only a subungual haematoma was noted. Radiographs of the effected thumb demonstrated a round, lytic lesion with an accompanying hairline fracture on the distal phalanx of the left thumb. The radiologist suggested a differential diagnosis of enchondroma should be considered.

The patient was referred for a routine plastic surgery outpatient appointment. Curettage sampling of the lesion was performed and a cement filler was used to prevent further pathological fractures.

The biopsy report stated that the sample contained normal bone tissue with no evidence of enchondroma or other malignancy and the patient was discharged without any further complications.

  • dermatology
  • trauma
  • orthopaedics
  • radiology
  • plastic and reconstructive surgery

Statistics from


  • Contributors NJS, PC and MK provided significant contribution to the research, writing and review of the article and case.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.