Trigger finger: Difference between revisions
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*Also known as stenosing tenosynovitis | *Also known as stenosing tenosynovitis | ||
*Associated with: | *Associated with: | ||
**Diabetes | **[[Diabetes]] | ||
**Rheumatoid arthritis | **[[Rheumatoid arthritis]] | ||
**Amyloidosis | **[[Amyloidosis]] | ||
**Repetitive strain | **Repetitive strain | ||
**"Texting tendonitis" | **"Texting tendonitis" | ||
==Clinical Features== | ==Clinical Features== | ||
[[File:TriggerFinger.webm.jpg|thumb|An example of trigger finger affecting the ring finger.]] | |||
*Delayed, painful extension of digit | *Delayed, painful extension of digit | ||
*Most commonly ring finger | *Most commonly ring finger | ||
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*Tenderness at A1 pulley (distal palm) | *Tenderness at A1 pulley (distal palm) | ||
*Patients need to manually straighten finger with other hand | *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 | *Contrast with [[Dupuytren’s contracture]], which is not usually associated with pain or history of repetitive overuse | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
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==Disposition== | ==Disposition== | ||
*Outpatient management | |||
==See Also== | ==See Also== | ||
Latest revision as of 14:19, 12 December 2020
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
- Distal finger
- Other finger/thumb
- Boutonniere deformity
- Mallet finger
- Jammed finger
- Jersey finger
- Trigger finger
- Ring avulsion injury
- De Quervain tenosynovitis
- Infiltrative tenosynovitis
- Metacarpophalangeal ulnar ligament rupture (Gamekeeper's thumb)
- Hand
- Wrist
- Drummer's wrist
- Ganglion cyst
- Lunotriquetral ligament instability
- Scaphoid fracture
- Extensor digitorum tenosynovitis
- Compressive neuropathy ("bracelet syndrome")
- Intersection syndrome
- Snapping Extensor Carpi Ulnaris
- Vaughn Jackson syndrome
- General
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
- Outpatient management