Digits, fingers and thumb
In Snomed CT the thumb is not a finger and is therefor always separated from the fingers. In the Netherlands the care professionals consider the thumb as a finger, wich makes it difficult for us to translate these concepts. We found a way to do this, but we do have problems when there are concepts of finger and not with thumb and how to interpret these concepts.
For example:
427110004 |Structure of bursa of finger (body structure)| and there is no structure of bursa of thumb.
372168009 |Bone part of distal phalanx of finger (body structure)|, there is no thumb variant
For these examples I requested the thumb variant but I am sure there are more of these examples in Snomed
Another example are disorders and procedures
708866002 |Arthrotomy with drainage of joint of finger (procedure)| with procedure site finger structure
Strictly, you can't use this procedure when its performed on the thumb, because its not a finger in Snomed. But there is no Arthrotomy with drainage of joint of thumb (procedure)| in Snomed. Or do they actually mean digit here and should the procedure site change?
In summary, in our opinion, it gets too complicated to model the finger-thumb-digits anatomy in this way. Are there more countries who are struggling with this? Wouldn't it be more useful to avoid the term/concept 'finger' and talk about digits and the distinct names of the digits? I hope to hear experiences of other countries how they deal or would deal with this issue.
Comments
@Yongsheng, I think the proposed naming conventions look good. (It might be worth considering allowing the 'x finger' synonyms to help with searching but I don't mind. (Similarly, there's other synomyms viable for the toes, e.g. hallux)
This doesn't entirely address @Elze's problem though.. I'm not sure if 'fingers' should include thumb, but I suspect not - given the proposed naming conventions there's clearly a perceived ambiguity. I say "digit" is better than finger, if the specific digit isn't specified. I would say there's limited value in having both "procedure on finger" AND "procedure on digit" concepts. The fact this discussion exists hints at ambiguity...
@Matt Cordell, many thanks for the feedback. The key issue is whether finger should include thumb or not. The interpretation could be different for different countries or regions. I agree that 'digit' is preferred when the specific digit is not specified to avoid potential ambiguity.
The draft naming convention has been developed at 8. Naming convention for anatomy Both digit and finger/toe are used for descriptions. We would like to know if a consensus can be reached for the classification of fingers whether it includes the thumb.
Some 'missing' concepts have been submitted and addressed for the July 2018 release. Please submit any other requests via the CRS for inclusion in SNOMED CT.