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Psychologically disturbed children who bite and suck their fingers cause thickenings that resemble knuckle pads to occur in the skin in the traumatized areas. Patients with bulimia who use their knuckles or fingers to induce emesis sometimes develop fibrotic papules resembling knuckle pads. [8] Some cases of knuckle pads are familial.
There is no evidence that cracking knuckles causes any damage such as arthritis in the joints. However, a couple of reports in the medical literature are available associating knuckle cracking with injury of the ligaments surrounding the joint or dislocation of the tendons ( attachments of muscles to bones) which improved with conservative treatment.