Summary about Disease
Boutonniere deformity is a condition affecting the fingers, characterized by a bent-down (flexed) middle joint (proximal interphalangeal joint or PIP) and an over-extended (hyperextended) outermost joint (distal interphalangeal joint or DIP). This occurs due to a disruption or tear of the central slip of the extensor tendon, which normally straightens the middle joint of the finger.
Symptoms
Inability to straighten the middle joint of the finger (PIP joint).
Bent-down posture of the middle joint.
Over-extension of the outermost joint (DIP joint).
Pain and swelling in the middle joint, especially initially.
Stiffness of the affected finger.
Causes
Injury: Direct trauma to the top of the middle joint (PIP joint), such as a cut or blow.
Rheumatoid Arthritis: Inflammation from rheumatoid arthritis can weaken or rupture the extensor tendon.
Other inflammatory conditions: Psoriatic arthritis, lupus, and other autoimmune disorders.
Burns: Scarring from burns can cause tendon contracture.
Dislocation: A dislocation of the PIP joint can damage the extensor tendon.
Medicine Used
Pain relievers: Over-the-counter pain relievers like ibuprofen or naproxen (NSAIDs) can help reduce pain and inflammation. Prescription pain medications may be needed in some cases.
Corticosteroid injections: Injections into the PIP joint can reduce inflammation, but repeated injections can weaken the tendon.
Disease-modifying antirheumatic drugs (DMARDs): For boutonniere deformity caused by rheumatoid arthritis or other inflammatory conditions, DMARDs may be prescribed to manage the underlying condition.
Is Communicable
No, boutonniere deformity is not communicable or contagious. It is caused by injury, inflammation, or other non-infectious factors.
Precautions
Protect your hands and fingers from injury: Wear gloves when doing activities that could put your hands at risk.
Seek medical attention promptly: If you injure your finger, see a doctor to get it evaluated.
Follow your doctor's instructions: If you are diagnosed with boutonniere deformity, follow your doctor's instructions for treatment.
Manage underlying inflammatory conditions: If your boutonniere deformity is caused by rheumatoid arthritis or another inflammatory condition, work with your doctor to manage the condition.
How long does an outbreak last?
Boutonniere deformity is not an "outbreak" in the sense of an infectious disease. Once the condition develops, it will persist unless treated. The time for recovery depends on the severity of the injury, the promptness of treatment, and the individual's response to therapy. Early treatment usually results in better outcomes. Without treatment, the deformity can become permanent.
How is it diagnosed?
Physical examination: A doctor will examine your finger and assess its range of motion. The characteristic bent-down middle joint and over-extended outermost joint are usually easily identifiable.
Medical history: The doctor will ask about any recent injuries, underlying medical conditions, and symptoms.
X-rays: X-rays may be taken to rule out any fractures or other bone abnormalities.
Timeline of Symptoms
Initial injury: Pain, swelling, and difficulty straightening the finger may occur immediately after the injury.
Early stage: The finger may be painful and swollen. You may be able to straighten the finger passively (with help), but not actively.
Developing stage: The middle joint (PIP) becomes progressively more difficult to straighten and the outermost joint (DIP) becomes hyperextended.
Established deformity: The bent-down posture of the middle joint and over-extension of the outermost joint become fixed and difficult to correct. This can occur over weeks to months if left untreated.
Important Considerations
Early diagnosis and treatment are crucial: The earlier the condition is diagnosed and treated, the better the chance of restoring full function to the finger.
Compliance with treatment is essential: Whether the treatment involves splinting, therapy, or surgery, it is important to follow your doctor's instructions carefully.
Surgery may be necessary: In some cases, surgery may be needed to repair the extensor tendon or correct the deformity.
Long-term outlook: With prompt and appropriate treatment, most people with boutonniere deformity can regain good function of their finger. However, some stiffness or weakness may persist.