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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.
In some cases, many knuckles can be affected. Inflammation in the knuckles can also cause knuckle pain and swelling. Medical conditions, such as rheumatoid arthritis, which is a chronic autoimmune disease, and is characterized by joint inflammation, will also cause knuckle pain and swelling.