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Am Fam Physician. 2022;105(5):549-550

Author disclosure: No relevant financial relationships.

A 16-year-old patient with no significant medical history presented with pain and new deformity of his left middle finger the Monday after playing in a Friday night football game. He reported that he jammed his finger while attempting to catch a punt return and dropped the ball. The athletic trainer evaluated the patient's finger on the sidelines and buddy taped it to the adjacent finger. He played the rest of the game without issue.

Over the weekend, the patient noticed that his injured finger was involuntarily flexed at the middle knuckle, and the tip was extended (Figure 1). He had no numbness or tingling. The middle knuckle was the most tender part of the injured finger, and the patient was apprehensive about moving it.

Question

Based on the patient's history and physical examination findings, which one of the following is the most likely diagnosis?

  • A. Central slip injury.

  • B. Jersey finger.

  • C. Mallet finger.

  • D. Sagittal band injury.

  • E. Volar plate injury.

Discussion

The answer is A: central slip injury. The term jammed finger can refer to many injuries. The position of the finger during the injury, whether it is flexed or extended, and which joint is impacted are important factors in diagnosing a finger injury. The sport or activity associated with the injury can also be helpful. Radiography of the hand, particularly anteroposterior, lateral, and oblique views, should be performed to assess for dislocation, fracture, or level of tendon retraction and to guide management.1,2

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The editors of AFP welcome submissions for Photo Quiz. Guidelines for preparing and submitting a Photo Quiz manuscript can be found in the Authors' Guide at https://www.aafp.org/afp/photoquizinfo. To be considered for publication, submissions must meet these guidelines. Email submissions to afpphoto@aafp.org.

This series is coordinated by John E. Delzell Jr., MD, MSPH, associate medical editor.

A collection of Photo Quiz published in AFP is available at https://www.aafp.org/afp/photoquiz

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