No-name joints

Two mornings ago, I awoke feeling generally good and energetic, but very painfully afflicted by osteoarthritis, in both shoulders and both elbows and both wrists and all the joints of both hands — but worse in my already damaged right hand, and especially in its middle (and otherwise least damaged) finger, and especially in the top joint of that finger, just under the fingernail, which was swollen and reddening. Swollen so much I couldn’t straighten it out.

Then, while I was getting my first mug of tea, an operation that requires holding a mug under a spout as it fills with very hot water, I realized, simultaneously, that I was incapable of holding onto the mug as it filled and so was about to drop the whole thing on the floor (I immediately set it down and switched to doing everything with my left hand, which was agonizing but achievable); and that I had no ordinary name, or even a fancy anatomical term, for that swollen and screamingly painful joint on my right hand. I had a description — “the top joint of that finger, just under the fingernail” — but no name; in fact, I had no name for any of the hand joints other than those at the base of the fingers: the knuckles, in my usage.

It was somewhat worse yesterday, though I could use a mouse and type, cautiously, with my right index finger. I took a photo, using my iPad — a minimal instrument, and very hard to manage for using an afflicted left hand to shoot a worse-afflicted right hand. Not a triumph of the photographer’s art, and better at showing some of the devastation of ulnar nerve damage (the useless, permanently contracted little finger, the pit of vanished muscle between my thumb and index finger) than the terribly swollen joint on my middle finger:

(#1) Thumb, index finger, middle finger, ring finger, little finger, those are everyday names; but what about the rest?

Still worse this morning, the Bad Joint more swollen and redder than before, every stroke typing a litte stab of pain. Meanwhile, my applications of Biofreeze gel (“fast acting menthol” for “temporary relief from minor aches and pains of sore muscles & joints associated with arthritis – backache – strains – sprains”) no longer helps.

But since I can’t fix the old daily electric-strike pain of the ulnar nerve damage  or the newer pain of osteoarthrits, which moves mysteriously around my body from day to day, I’ll talk about words.

Having a word for it, or not. In the domain of  bodyparts / body parts. From a posting of mine on LLog on 12/2/06 “Does anyone have a word for this? Probably not.”:

I argue that a useful interpretation of word for in language L is something like ‘ordinary-language fixed expression of some currency’ (olfesc)

A fixed expression, not a description — see above on my afflicted middle finger joint. And in ordinary language, not a technical expression known only to specialists. Ordinary English has knee, ankle, wrist, thigh, thumb, knuckle(s), etc., and a lot of N + N compounds, like knee cap, shoulder blade, fingernail /  toenail, and ear lobe, and a lot of fixed Adj + N nominals, like the finger names.

But there are plenty of gaps. The groove between the nose and the upper lip — the technical anatomical term is philtrum — or the depression at the back of the knee (analogous to the armpit), the popliteal fossa. Or, of course, all those joints in the hand.

(Every so often, people devise everyday names to fill these gaps — kneepit (on analogy with armpit), for example. These innovations are (rarely) olfescs, because, like dialect terms, they haven’t spread to become expressions of some currency.)

A diagram from the American Society for Surgery of the Hand:

(#2) The top, or nail, joint (my ad hoc description), the distal interphalangeal (DIP) joint; the middle joint, the proximal interphalangeal (PIP) joint (the thumb has no middle joint); and the metacarpalphalangeal (MCP) joint (the knuckle in a narrow sense)

There’s an ambiguity in knuckle that I was unaware of. Consider, from OED2 on the noun knuckle

2. a. … The bone at a finger-joint, which forms a rounded protuberance when the hand is shut; esp. applied to those at the roots of the fingers.

This has knuckle in a broad sense, taking in all of the finger joints — with the MCP joints the knuckles par excellence.

Hand joints in action: the fist. From NOAD:

noun fist: a person’s hand when the fingers are bent in toward the palm and held there tightly, typically in order to strike a blow or grasp something.

The action of making a fist is clenching. More from NOAD:

verb clench: (with reference to the fingers or hand) close into a tight ball, especially when feeling extreme anger: [with object]: she clenched her fists, struggling for control | [no object]: John’s right hand clenched into a fist | (as adjective clenched): he struck the wall with his clenched fist.

There’s some unclarity (in my mind, and possibly in these definitions) with respect to the line between a fist and a clenched fist. But in any case, a (clenched) fist displays the hand joints as a set:

(#3) Inner view of a (clenched) fist, middle joint (PIP) on the left, top joint (DIP) tucked under

(#4) Outer view of a (clenched) fist, knuckle (MCP joint) on the top, middle (PIP) joint folded under

There are various sociocultural significances of the raised clenched fist, or clenched-fist salute; the symbolism is so culturally significant that clenched fist by itself is often understood to refer to a raised fist. Otherwise:

— the fist is clenched in anger, for hitting

— there’s a clenched fist syndrome, a rare psychiatric condition in which the patient keeps one or both hands tightly clenched

— it’s a common phlebotomist’s practice to ask a patient to make a fist before or during a blood draw, though the practice has been challenged

— fists serve as greetings in fist bumps

— and there’s the sexual practice of fisting

(See my 4/11/18 posting “On the fisting patrol” on the last of these, and some of the others.)

More hand parts: the thumb and its neighborhood. Last mentioned in connection with my ulnar nerve damage and its consequences for the parts of my right hand.

First note, on the base of the thumb. There’s the fleshy part, what most people think of when they hear the description the base / ball of the thumb. The anatomical term appears to be the thenar eminence (thenar /ϴínar/). The joint at the base of the thumb is the entertainingly named the carpometacarpal (CMC) joint.

And then there’s the area between the thumb and index finger, so totally eroded on my right hand. The anatomical term appears to be the thenar webspace.

I’m afraid that the thenar terminology is unlikely to catch on.

2 Responses to “No-name joints”

  1. Robert Coren Says:

    I would argue that the space behind the knee is more nearly analogous to the inside of the elbow (which also has no common name that I can think of); the leg analogue of the armpit is the groin.

  2. arnold zwicky Says:

    Joint report 3/7: the middle finger top joint is still red and swollen, fingers fingers are but not so painful. However, the *middle* joints on my ring and little fingers are now red and swollen, and terribly painful. Oi.

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