Differential Diagnosis for Right Middle Finger Injury
Single most likely diagnosis
- Subungual hematoma: This condition is likely due to the trauma from breaking the fingernail really low down, which can cause bleeding under the nail, leading to tenderness and pain.
Other Likely diagnoses
- Fingernail bed laceration: The injury could have caused a laceration to the nail bed, which may be painful and tender, especially if it becomes infected.
- Distal phalanx fracture: A fracture to the tip of the finger is possible, especially if the force of removing the cushion was significant, which could cause ongoing tenderness.
- Nail bed infection: Bacteria can enter the nail bed through the broken nail, causing an infection, which would explain the ongoing tenderness.
Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Osteomyelitis: Although rare, an infection of the bone can occur, especially if the wound becomes infected, which can lead to serious complications if left untreated.
- Compartment syndrome: This is a rare but serious condition where increased pressure within the finger compartments can lead to nerve and muscle damage, which requires prompt medical attention.
Rare diagnoses
- Tumor: Although extremely rare, a tumor could be present, which may have been irritated by the injury, causing tenderness and pain.
- Raynaud's phenomenon: This condition affects blood flow to the fingers and could be triggered by the injury, leading to pain and tenderness, especially in response to cold temperatures or stress.