Garrod's pad
Garrod's pads (also known as violinist's pads[1]) are a cutaneous condition characterized by calluses on the dorsal aspect of the interphalangeal joints,[2] i.e. the back side of the finger joints. They are often seen in violin, viola, and cello players, along with fiddler's neck and other dermatologic conditions peculiar to string musicians.[2] Although Garrod's pads are conventionally described as appearing on the proximal interphalangeal joint, distal interphalangeal joint involvement has also been described.[2]
Garrod's pads are named after Archibald Garrod who first documented them in 1904 in association with Dupuytren's contracture.[3] H.A. Bird described them as an incidental finding in a professional violinist and proposed that they arise in such cases due to repeated extreme tension of the extensor tendons over the interphalangeal joints.[4] Bird noted that violin players use the left hand for a markedly different task than the right hand, with the extensor tendons in the left hand subjected to considerable tension, and that Garrod's pads only arise on the left hand in such cases. This unilateral finding differentiates the occupational hazard of Garrod's pads from more significant disorders. Among violinists and violists, Garrod's pads apparently arise as a protective mechanism for the skin and subcutaneous tissues above the tendons; Bird notes that they do not protect against external trauma unlike most calluses.[4]
Patients with Dupuytren's contracture are four times more likely to have coexisting Garrod's pads.[5][6]
See also
- Knuckle pads
- Harpist's finger
- Fiddler's neck
- Cellist's chest
- Cello scrotum
- Paget-Schroetter syndrome
- List of cutaneous conditions
- List of eponymously named medical signs
References
- ^ Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. ISBN 978-1-4160-2999-1.
- ^ a b c Rimmer, S.; Spielvogel, R. L. (1990). "Dermatologic problems of musicians". Journal of the American Academy of Dermatology. 22 (4): 657–663. doi:10.1016/0190-9622(90)70093-W. PMID 2138638.
- ^ Garrod, A. E. (1904). "Concerning Pads upon the Finger Joints and their Clinical Relationships". British Medical Journal. 2 (2270): 8. doi:10.1136/bmj.2.2270.8. PMC 2354178. PMID 20761632.
- ^ a b Bird, H. A. (1987). "Development of Garrod's pads in the fingers of a professional violinist". Annals of the Rheumatic Diseases. 46 (2): 169–170. doi:10.1136/ard.46.2.169. PMC 1002087. PMID 3827341.
- ^ Cutis. Technical Publishing Company. 1994. p. 160. Retrieved 13 November 2017.
- ^ Young, Christopher J.; Gladman, Marc A. (2013). Examination Surgery: A Guide to Passing the Fellowship Examination in General Surgery. Elsevier Health Sciences. p. 213. ISBN 9780729541480. Retrieved 13 November 2017.
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