When cracking knuckles leaves a mark: Garrod’s nodes in an adolescent

Garrod’s pads are a rare, benign, and asymptomatic superficial fibromatosis involving the finger joints. Although they are more common in adulthood, they can also appear in the pediatric and adolescent population.

We present the case of a 13-year-old female patient with Garrod’s pads on the distal interphalangeal joints of both hands. The physical examination revealed firm, subcutaneous prominences without signs of inflammation, pain, or limited joint mobility. Rheumatological conditions were ruled out through a complete clinical and laboratory evaluation, including measurement of acute-phase reactants, rheumatoid factor, and antinuclear antibodies. A detailed anamnesis identified a compulsive knuckle-cracking habit as the only relevant history. Following the recommendation to stop the habit, there was significant regression of the lesions within a few months.

This case highlights the importance of a thorough history-taking in pediatrics, as the diagnosis of Garrod’s pads is based on the clinical history and ruling out other causes. Identifying and eliminating the cause of trauma, such as knuckle cracking, is fundamental for the management of this condition, which is self-limiting and has an excellent prognosis once the stimulus ceases. The correct identification of this benign condition reassures patients and avoids unnecessary tests or referrals.