Felon Differential Diagnoses

Updated: Mar 11, 2021
  • Author: Brandon Stein, MD; Chief Editor: Steven C Dronen, MD, FAAEM  more...
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Diagnostic Considerations

Blunt trauma to the fingertip may mimic a felon, but the history should suggest the correct diagnosis. Herpetic whitlow may cause fingertip pain, but it is not typically erythematous or tensely swollen, in addition vesicles should be presents. Orf infections may be mistaken for a felon however these are generally painless and have clear drainage. [4] A pyogenic tenosynovitis may also mimic a felon. A paronychia may cause pain, erythema, and swelling, but the tenderness and swelling are typically greater on the extensor side of the digit. A paronychia may progress to a felon. If the swelling and pain spread to the DIP joint or proximally, consideration for tenosynovitis or a septic joint should be made.

Differential Diagnoses