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Psychologically disturbed children who bite and suck their fingers cause thickenings that resemble knuckle pads to occur in the skin in the traumatized areas. Patients with bulimia who use their knuckles or fingers to induce emesis sometimes develop fibrotic papules resembling knuckle pads. [8] Some cases of knuckle pads are familial.
Knuckle pain may develop as a result of conditions affecting any of the structures in the knuckle, including skin, nerves, muscles, joints, tendons, bones, ligaments, blood vessels, and connective tissue. Injury from trauma and osteoarthritis are common causes of knuckle pain.n many cases, several knuckles may be affected. Inflammation within the knuckle causes swelling and pain. Further, rheumatoid arthritis, a chronic autoimmune disease characterized by joint inflammation, and other arthritis-related conditions are associated with knuckle pain, again due to inflammation and swelling.