OpenHealth Q&A

Understanding My 52M FOOSH Injury: Elbow and Finger Concerns

Do I have a direct soft tissue injury to my pinky’s proximal interphalangeal joint from my fall, or is this an example of inflammation caused by the ulnar nerve, possibly indicating complex regional pain syndrome (CRPS)? As a 52-year-old male, I recently experienced a fall from a standing position on some slippery ice. In an attempt to brace myself, I used my arms but futilely ended up landing heavily on my elbow. At the emergency room, an X-ray examination revealed significant fluid buildup in the elbow joint, as indicated by the sail sign and posterior fat pad sign, although no fractures were identified. Additionally, an old, previously unnoticed Hill-Sachs lesion was discovered, and I was sent home with a protective sling. That first night, I developed a fever, reaching 102 degrees after taking Paracetamol, and the initial three days were marked by excruciating pain. I experienced “hot and tingling” sensations in my pinky and ring fingers, while my thumb, index, and middle fingers felt “cold and numb” right from the start. By the third day, I suspected that I had either reduced a subluxation or dislocation of my shoulder through manipulation, which alleviated some shoulder pain. On day four, I felt discomfort and slight inflammation in the proximal interphalangeal joint of my pinky. However, I dismissed it as a minor injury overshadowed by the severe pain in my elbow and shoulder. On day eight, further X-rays of the shoulder, elbow, and finger showed no fractures. The only remark from the radiologist focused on the significant joint effusion in my elbow. Meanwhile, I noted anterior–inferior displacement of the humeral head related to the glenoid in the initial X-ray, alongside the Hill-Sachs lesion; this displacement was absent on the day eight scan. Observations also revealed joint effusion in the pinky’s PIP joint. Fast forward to day 26: My elbow is gradually improving, but I still struggle to fully extend or flex it, though flexing remains notably more challenging. Rotational movements of my forearm continue to cause pain, and there’s a lingering sensation of heaviness and fullness in my elbow, with bruising nearly faded. Unfortunately, my shoulder still hurts, and there’s discomfort in the overarm muscles. I experience tingling sensations in my thumb, index, and middle fingers, yet I can manage to form an ‘OK’ sign. Concerning my pinky, its PIP joint remains red, inflamed, and significantly painful, occasionally turning bluish or purplish, and appearing more problematic than during the first few weeks. Extending my pinky becomes increasingly difficult; when stretching all fingers, it remains bent at about a 90-degree angle unless I concentrate hard to fully extend it. In various positions, tingling and coldness in my hand fluctuate, and numbness or tingling can also radiate to my elbow, overarm, or forearm. On certain evenings, I notice swelling in the thumb and the tips of my index and middle fingers. The interphalangeal joint of my thumb remains painful during movement, yet there’s an absence of redness or significant inflammation, aside from occasional swelling. My arm does feel weaker, but I am capable of holding a glass and pushing or pulling objects; however, I cannot push myself off the couch or similar surfaces.

Answers (1)

2/5/2026, 3:01:10 PM

OpenHealth AI

It sounds like you’ve been through quite a challenging experience with your FOOSH (Fall On Outstretched Hand) injury. Given your symptoms and history, you're dealing with multiple issues that impact your elbow, pinky finger, and potentially your shoulder. Let’s break this down:

Main Points:

1. Your symptoms suggest both a soft tissue injury to your pinky’s PIP joint and possible ulnar nerve involvement.
2. There might be complications like complex regional pain syndrome (CRPS), but it's crucial to monitor your symptoms closely.

Explanation:

• Soft Tissue Injury: The inflammation and pain in your pinky’s proximal interphalangeal joint along with the redness and difficulty extending it suggest a soft tissue injury or possible ligament strain. The joint effusion noted in the imaging could be linked to this injury.
• Ulnar Nerve Involvement: The tingling and coldness in your fingers may indicate irritation of the ulnar nerve, which could be related to your elbow injury or further irritation stemming from the pinky. This nerve innervates the small finger and part of the ring finger, explaining your symptoms.
• CRPS: While there are characteristics of CRPS (such as changes in skin color and temperature, pain, and swelling), it typically requires specific diagnostic criteria.

Next Steps:

1. Self-Care and Monitoring:

   • Rest and Elevation: Keep your injured arm elevated to reduce swelling. Avoid activities that stress the elbow and pinky as much as possible.
   • Ice Therapy: Apply ice packs to your elbow and pinky for 15-20 minutes, several times a day, to help reduce inflammation and pain.
   • Gentle Movement: Start doing gentle range-of-motion exercises for your fingers and elbow, within a comfortable limit, to prevent stiffness. Avoid forcing extension of the pinky if it causes pain.

2. Pain Management:

   • Continue taking over-the-counter pain relievers like Paracetamol or Ibuprofen, following the recommended dosages, to manage pain.
   • If symptoms worsen or you notice increased swelling or discoloration, consider discussing stronger pain management options.

3. Neurological Symptoms:

   • Keep track of the sensations in your fingers (tingling, numbness). Document any changes in symptoms, noting if they correlate with your activity levels.

4. Consultation Approach:

   • While I understand you're looking for guidance, these complex symptoms may benefit from the review of a healthcare provider, particularly an orthopedic specialist or physical therapist, when possible. They can provide tailored exercises and evaluate if additional imaging or interventions (like splinting or a specific rehabilitation program) might be appropriate.

Remember, healing from these types of injuries can take time, and being patient while following a structured self-care approach is key. If anything feels alarming or doesn't improve, don’t hesitate to seek professional advice. Take care!