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February 13, 1987

Joystick Digit

JAMA. 1987;257(6):782. doi:10.1001/jama.1987.03390060072023

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To the Editor.—  We report two cases of trigger finger caused by repetitive joystick manipulation while playing video games, a condition we have termed joystick digit.

Report of Cases.—Case 1.—  An 11-year-old boy complained of awakening with his dominant ring finger locked in flexion. He was able to unlock the finger, but observed triggering with motion. There had been no previous episodes. He played video games using joysticks for prolonged intervals daily, occasionally for as long as six hours (Figure). Examination of the hand revealed a large nodule in the flexor tendon sheath of the ring finger associated with triggering. The long finger exhibited a similar nodule but did not trigger. The other hand was normal. Treatment involved oral anti-inflammatories and avoiding use of the joystick.

Case 2.—  A 14-year-old boy, an admitted computer "hacker," presented with triggering in his dominant long finger. He used his joystick control