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Severe temporary pain in 2nd digit at night
Just wanted to get advice from my fellow rads.
Recently, I wake up at night with pretty severe pain in my index (2nd phalanx) finger particularly at the PIP/DIP of my dominant hand. I assume it’s overuse from scrolling but the odd thing is when I wake up in the morning, my finger doesn’t hurt at all. Because its transient, I didn’t really think about it until this morning. Has anyone dealt with this before? Is this a harbinger for something worse?
Am I developing OA at the joint or some sort of flexor tendon issue?
Just trying to decide what to do ergonomically to prevent this.
Thanks for your thoughts. -
21 Replies
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Who knows what’s going on internally.
But ergonomics are critical and repetitive use is bad for human body parts.
Do whatever you have to do to mix it up before it gets worse.
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Quote from Theforce111
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Just trying to decide what to do ergonomically to prevent this.
…….
Interesting where my mind went with this…..
I remember as a resident we’d go into the room with the sonographers for exams. One time it was a young woman for a pelvic U/S. Sonographer asks “Why are you getting this scan?” to which the patient answers: “It hurts when I have anal sex.” My immediate thought was “Have you ever considered NOT having anal sex?” LOL On a less salacious note, I’m reminded of a saying from my chess playing days: “If what you’re doing isn’t working, stop doing it.”
So anyway, back to the OP. My thoughts were either repetitive use (i.e. scrolling, which you mention, so stop doing what you’re doing and do something different) and/or “Welcome to old age.” I sometimes switch my mouse to my non-dominant hand, which can be cumbersome, but does help with the repetitive motion issues. Good luck.
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‘Its not a Dumor’
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As far as I’m concerned, waking up in the middle of the night from pain warrants imaging in almost all cases. May be nothing, but to wake you up from sleep, warrants full attention. Oh and I will say overall, im an under imager, most things I dismiss without need for imaging.
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All anyone here can do is provide you with tips for ergonomics and maybe a few personal anecdotes. If you want medical advice you need to see your doc, not an online forum.
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Quote from striker79
As far as I’m concerned, waking up in the middle of the night from pain warrants imaging in almost all cases. May be nothing, but to wake you up from sleep, warrants full attention. Oh and I will say overall, im an under imager, most things I dismiss without need for imaging.
I appreciate the concern. I am pretty sure this is related to work and overuse from radiology since it’s my finger I use most with the mouse wheel. I definitely feel worse after a call shift. I was playing with some cine options at work today to see if I could offload some of scrolling duties.
If I was worried about something else, I would not have posted in this forum.
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Tendonitis.
Imaging is absolutely unnecessary.
Used to get it playing bball.
NSAIDs work amazingly.
Adjust your ergonomics. -
Quote from Theforce111
Quote from striker79
As far as I’m concerned, waking up in the middle of the night from pain warrants imaging in almost all cases. May be nothing, but to wake you up from sleep, warrants full attention. Oh and I will say overall, im an under imager, most things I dismiss without need for imaging.
I appreciate the concern. I am pretty sure this is related to work and overuse from radiology since it’s my finger I use most with the mouse wheel. I definitely feel worse after a call shift. I was playing with some cine options at work today to see if I could offload some of scrolling duties.
If I was worried about something else, I would not have posted in this forum.
In that case make sure you have a good mouse with frictionless scroll. Most Logitech devices have this capability. Click-and-drag cine scrolling options are usually less strain than the mouse wheel.
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Yeah, but since the pain is worse after a call shift, I would agree with above that an overuse injury like tendinitis is most likely. I think osteoarthritis would be less likely, especially if there isnt pain in any other joints. OP, have you tried learning to use the mouse with your contralateral hand? It may be a little slow and weird at first, but its a game changer once you get used it.
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Likely some component of tendon injury/inflammation. The fact that it’s worse at night is likely positional as we tend to flex wrists/hands/fingers when we sleep (same reason CTS can be symptomatic during sleep)
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try alternate input devices to scroll through cases (pending that your computers aren’t locked down too much). There are multiple recs in older posts for such mice, scroll wheel type devices, etc. I personally believe that using the scroll wheel to look at large or small data sets repetitively is very stressful on the finger and wrist, and needs to be dealt with. Good luck
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What boomer/jd/cistern said.
I would absolutely stop using the scroll wheel. My equivalent is the push/drag mechanism on the mouse. Way better on wrist. Also consider an ergo eval, hand position is very important. And as on a prior thread, I stretch flexor/extensor compartments of forearms before a long shift. -
Happy wife happy life
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Very simple and fast to get an xray and minimal radiation dose. If it’s completely normal – great. At least you have an answer as to whether or not its simply tendonitis or something else, and you’ve also got a baseline to something that may bother you for the rest of your life since you’re a radiologist. You’ve probably spent more time thinking about whether or not to get it imaged than the time it would have taken to image it.
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My money is on some sort of tendinitis/overuse injury as well.
But one of the benefits of our job is we can image ourselves for basically anything. I agree with striker, at minimum I’d sneak in for a quick Xray first.
If we have last second cancellations on the scanner, I also sneak in a couple tailored MR sequences if I have a twisted ankle or some minor orthopedic issue.
I already would have gotten a hand X-ray and maybe 10-15 minutes of a partial MR before thinking about it too much 🙂 -
Disagree with those who advocate imaging selves “off the record”. One is ethically bound to not treat oneself, and it is often a violation of hospital or department policy to use imaging equipment off the books.
Plus, we are biased in such imaging. I know it’s easy to do, but it is not wise or ethical. Go through the proper channels and be evaluated. -
Youre a real blast at parties I bet!
Business owners write off all sorts of nonsense. We throw ourselves on a scanner under a test patient occasionally. Seems reasonable.
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Hope youre using a smooth scroll mouse wheel. Cant imagine the repetitive trauma Id do to my finger with a click wheel
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I try to avoid scrolling with the mouse wheel. I’ve had flexor tendinosis of my R index finger, which was painful, debilitating for several months. It gradually went away when I found alternative ways to scroll.
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A PACS without a click and drag option to scroll is not a PACS worth using.
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