Periostitis in the Thumb: When to Seek Orthopedic Care

Inflammation of the periosteum of the left thumb joint?

I have been experiencing joint pain in my left thumb due to playing volleyball.
I remember injuring my finger, and afterwards, I had symptoms of bruising and swelling.
Initially, I consulted a traditional Chinese medicine practitioner who diagnosed me with periostitis, but the recovery has been slow.
Later, I received anti-inflammatory treatment, and the swelling has decreased, but I still experience pain when applying force or bending the joint, to the point where I cannot exert any strength.
I also visited a martial arts clinic, where they suggested stretching and applying medicated patches, but it seems to have made the pain worse.

I would like to know if I should go to an orthopedic specialist for an X-ray.
Do orthopedic clinics typically have X-ray machines? I am considering visiting a nearby clinic instead of a large hospital due to the higher costs, but I am worried about seeing the wrong specialist.
I want to know what would be the best course of action since it has been a month since the injury.
Thank you!

Dai'er, 20~29 year old female. Ask Date: 2011/04/09

Dr. Wang Shouji reply Orthopedics

Based on your description, it is indeed necessary to determine if there are any issues with the bones.
The presence of bruising and swelling indicates that the injury is likely significant, and serious problems such as fractures, dislocations, or tendon ruptures should be ruled out.
Most orthopedic clinics should have X-rays available to assist in the diagnosis.
Wishing you a speedy recovery.

Reply Date: 2011/04/09

More Info

Periostitis, or inflammation of the periosteum (the connective tissue surrounding bones), can occur in various parts of the body, including the thumb, especially after trauma such as a sports injury. In your case, the pain and swelling in your left thumb following a volleyball incident suggest that you may indeed be experiencing periostitis, possibly in conjunction with other injuries like a fracture or ligament strain.

Given that you initially sought treatment from a traditional Chinese medicine practitioner, it’s important to recognize that while alternative therapies can provide relief for some, they may not always address underlying structural issues. The symptoms you describe—persistent pain, swelling, and difficulty using the thumb—indicate that the injury may not be healing properly or that there may be a more serious underlying condition, such as a fracture or tendon injury.

When to Seek Orthopedic Care
1. Persistent Symptoms: Since it has been a month since your injury and you are still experiencing significant pain and swelling, it is advisable to seek orthopedic care. Symptoms that do not improve with conservative treatment, such as rest and anti-inflammatory medications, warrant further investigation.

2. Inability to Use the Thumb: If you find it difficult to perform daily activities that require thumb movement or strength, this is a clear sign that you should consult an orthopedic specialist. They can assess the extent of your injury and recommend appropriate treatment.

3. Imaging Studies: An X-ray is a crucial step in diagnosing bone-related injuries. It can help identify fractures, dislocations, or other structural abnormalities that may not be visible through physical examination alone. Orthopedic clinics typically have X-ray facilities, and this imaging can guide the treatment plan.

4. Increased Pain or Swelling: If you notice that the pain is worsening or if the swelling is increasing, this could indicate complications such as infection or a more severe injury. Immediate medical attention is recommended in such cases.

Recommended Steps
- Visit an Orthopedic Specialist: Given your symptoms and the duration of your injury, it would be prudent to visit an orthopedic clinic. They can perform a thorough examination and order an X-ray to rule out fractures or other serious conditions.

- Avoid Self-Treatment: While alternative treatments like acupuncture or topical applications may provide some relief, they should not replace medical evaluation, especially when there is a possibility of a fracture or significant injury.

- Rest and Immobilization: Until you can see a specialist, try to rest your thumb and avoid activities that exacerbate the pain. Using a splint or brace can help immobilize the thumb and reduce strain.

- Pain Management: Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can help manage pain and inflammation in the meantime. However, consult with a healthcare provider before taking any medication, especially if you have underlying health conditions.

Conclusion
In summary, it is advisable to seek orthopedic care given your ongoing symptoms and the potential for a more serious injury. An orthopedic specialist can provide a comprehensive evaluation, including necessary imaging, to determine the best course of treatment. Early intervention can help prevent long-term complications and facilitate a quicker recovery, allowing you to return to your activities without pain.

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