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

Garrod's pads are a rare, benign, and asymptomatic superficial fibromatosis that affects 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. 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 analytical evaluation, which included measuring acute-phase reactants, rheumatoid factor, and antinuclear antibodies. A detailed anamnesis identified a compulsive knuckle-cracking habit as the only relevant antecedent. Following the recommendation to stop the habit, a significant remission of the lesions was observed within a few months.

This case highlights the importance of a thorough anamnesis in pediatrics, as the diagnosis of Garrod's pads is based on clinical history and the exclusion of other causes. Identifying and eliminating the traumatic etiology, such as knuckle cracking, is fundamental for the management of this condition, which proves to be self-limiting and has an excellent prognosis once the stimulus ceases. The correct identification of this benign entity avoids patient anxiety and unnecessary tests or derivations.