Trigger finger

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Background

  • Tenosynovitis of the flexor sheath of the finger or thumb as a result of repetitive use
  • Also known as stenosing tenosynovitis
  • Associated with:
    • Diabetes
    • Rheumatoid arthritis
    • Amyloidosis
    • Repetitive strain
    • "Texting tendonitis"

Clinical Features

  • Delayed, painful extension of digit
  • Most commonly ring finger
  • Finger clicking
  • Palpable fibrous nodule
  • Tenderness at A1 pulley (distal palm)
  • Patients need to manually straighten finger with other hand
  • Contrast with Dupuytren’s contracture, which is not usually associated with pain or history of repetitive overuse

Differential Diagnosis

Hand and finger injuries

Evaluation

  • Clinical diagnosis (radiographs not indicated)

Management

  • Conservative therapy
    • Rest
    • NSAIDs
    • Immobilization (buddy tape or finger splint)
  • Refractory cases may require steroid injection or surgery

Disposition

See Also

References