in fractures of the scaphoid the only finding may be tenderness localised in the anatomical snuffbox. Occasionally the bones of the hand, particularly the phalanges, may be involved in granulomatous or other generalised disorders such as sarcoidosis, Paget's disease or hyperparathyroidism. Acute dactylitis is characteristic of sickle ceil disease in children. Craves' disease, autoimmune hyperthyroidism, may be associated with finger clubbing and periosteal new-bone formation in the phalanges.

Beau Lines Nails
Fig. 2.29 The nail as a diagnostic aid. 13 Splinter haemorrhages. IB Onycholysis with pitting in psoriasis. 0 Beau's lines. E Leuconychia. U] Dilated capillaries in the proximal nailfold in systemic lupus erythematosus.

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