Anderson is a 14-year-old right-handed boy with six months of painless swelling in multiple fingers. 

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<p>Anderson is a 14-year-old right-handed boy with six months of painless swelling in multiple fingers.</p><p>There is no associated joint pain, redness or loss of function. There is no history of trauma or injury.</p><p>Anderson is a keen gamer and music producer, having learned piano from the age of six, but these hobbies have not been affected by the swelling.</p><p>He is systemically well, with no medical or family history of note.</p><p>On examination, there is bilateral symmetrical firm, non-tender fusiform swelling of the index and middle fingers, predominantly over the proximal phalanges and centred around the proximal interphalangeal joints (pictured).</p><p>Skin and joint examination findings are otherwise normal.</p><p>Blood tests show normal FBC, inflammatory and autoimmune disease markers, and X-rays reveal soft tissue swelling only.</p>

Dr Kate Kelso is a GP and medical editor at Australian Doctor.