Spontaneous painful subungual thumb haematoma

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.

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