An unusual case of peri-articular soft tissue finger swelling in an adolescent male: pachydermodactyly or pachydermoperiostosis?

Benign soft tissue swelling affecting the interphalangeal joints can sometimes be misdiagnosed as an arthropathy. Garrods fatty pads (knuckle pad syndrome) is a relatively common and harmless condition characterized by discrete fibromatous skin pads over the dorsum of the interphalangeal joints. We describe a case which clinically resembles the rare but benign condition of pachydermodactyly with some pathological features of the distinct syndrome of pachydermoperiostosis. The possibility of an overlap syndrome is discussed.