Hemophilic Pseudotumor of the Distal Phalanx

Haemophilia is one of the hereditary recessive diseases linked to sex-induced coagulation disorder and is characterized by bleeding episodes. This report presents a rare involvement of the distal phalanx hemophilic pseudotumor.

A 21-year-old man was crushed by a closing door 18 months before. The distal phalanx was fractured, and a large hematoma developed under the nail plate, which separated the nail plate from its bed. Eighteen months after the injury, plain radiographs demonstrated an expansile lesion with extensive destruction of the distal phalanx. Regarding the patient’s history and abnormal clotting tests, the development of a hemophilic pseudotumor was considered at the distal phalanx due to the enlarging nature of the coagulum, which induced compression and pressure necrosis on the adjacent bone and structures.

Hemophilic pseudotumors in the small bones are rarely reported. After a minor traumatic injury in hand, exact management and coagulopathy control are important to prevent further complications.