A small dorsal bursa over the little finger MCP joint between the extensor mechanism and the joint capsule, prone to contact bursitis from repetitive ulnar-border hand trauma in contact sports, martial artists, and manual workers. It presents as a soft, fluctuant dorsal knuckle swelling at the fifth MCP.
Little finger MCP bursitis is common in boxers (boxer's knuckle) and in keyboard users from repetitive little finger impact. The swelling is transilluminable and distinct from MCP joint effusion, which is located deep to the extensor mechanism. Aspiration and protective padding are first-line. Septic MCP bursitis from bite wounds (fight bite) requires urgent irrigation and antibiotic therapy. Persistent or recurrent bursitis requires open bursectomy with concurrent extensor mechanism inspection.
Dorsal bursal inflammation at the fifth MCP from ulnar hand trauma or repetitive contact, producing a tender dorsal ulnar knuckle swelling managed with protective padding and injection.
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