Garrod's pads (also known as ''violinist's pads'') are a

cutaneous condition A skin condition, also known as cutaneous condition, is any medical condition that affects the integumentary system—the organ system that encloses the body and includes skin, nails, and related muscle and glands. The major function of thi ...

characterized by

callus A callus is an area of thickened and sometimes hardened skin that forms as a response to repeated friction, pressure, or other irritation. Since repeated contact is required, calluses are most often found on the feet and hands, but they may o ...

es on the dorsal aspect of the interphalangeal joints, i.e. the back side of the finger joints. They are often seen in

violin The violin, sometimes known as a '' fiddle'', is a wooden chordophone ( string instrument) in the violin family. Most violins have a hollow wooden body. It is the smallest and thus highest-pitched instrument ( soprano) in the family in regu ...

viola ; german: Bratsche , alt=Viola shown from the front and the side , image=Bratsche.jpg , caption= , background=string , hornbostel_sachs=321.322-71 , hornbostel_sachs_desc=Composite chordophone sounded by a bow , range= , related= *Violin family ...

, and

cello The cello ( ; plural ''celli'' or ''cellos'') or violoncello ( ; ) is a bowed (sometimes plucked and occasionally hit) string instrument of the violin family. Its four strings are usually tuned in perfect fifths: from low to high, C2, G ...

players, along with

fiddler's neck Fiddler's neck is an occupational disease that affects violin and viola players. It is a cutaneous condition usually characterized by redness, thickening, and inflammation on the left side of the neck below the angle of the jaw where the instrume ...

and other dermatologic conditions peculiar to string musicians. Although Garrod's pads are conventionally described as appearing on the proximal interphalangeal joint, distal interphalangeal joint involvement has also been described. Garrod's pads are named after

Archibald Garrod Sir Archibald Edward Garrod (25 November 1857 – 28 March 1936) was an English physician who pioneered the field of inborn errors of metabolism. He also discovered alkaptonuria, understanding its inheritance. He served as Regius Professor of ...

who first documented them in 1904 in association with

Dupuytren's contracture Dupuytren's contracture (also called Dupuytren's disease, Morbus Dupuytren, Viking disease, palmar fibromatosis and Celtic hand) is a condition in which one or more fingers become progressively bent in a flexed position. It is named after Guill ...

. H.A. Bird described them as an incidental finding in a professional violinist and proposed that they arise in such cases due to repeated extreme tension of the

extensor tendons In anatomy, extension is a movement of a joint that increases the angle between two bones or body surfaces at a joint. Extension usually results in straightening of the bones or body surfaces involved. For example, extension is produced by extendin ...

over the interphalangeal joints. Bird noted that violin players use the left hand for a markedly different task than the right hand, with the extensor tendons in the left hand subjected to considerable tension, and that Garrod's pads only arise on the left hand in such cases. This unilateral finding differentiates the occupational hazard of Garrod's pads from more significant disorders. Among violinists and violists, Garrod's pads apparently arise as a protective mechanism for the skin and subcutaneous tissues above the tendons; Bird notes that they do not protect against external trauma unlike most calluses. Patients with

are four times more likely to have coexisting Garrod's pads.

References

Skin conditions resulting from physical factors {{Dermatology-stub

See also

References