Infectious tenosynovitis: Difference between revisions
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==Clinical Manifestations== | ==Clinical Manifestations== | ||
*4 Kanavel signs: | |||
**(1) Finger held in slight flexion | |||
* | **(2) Fusiform swelling | ||
* Tenderness along | **(3) Tenderness along the flexor tendon sheath (late sign) | ||
* | **(4) Pain with passive extension of the digit (early sign) | ||
==Diagnosis== | ==Diagnosis== | ||
Revision as of 06:28, 31 December 2013
Background
- Infection of extensor tendons rarely result in loculated infections, but disruption of normal flexor tendon function can be dangerous as it may spread proximally involving the wrist/forearm (Parona space).
Etiology
- Trauma with direct inoculation
- Microbiology
- "Clean trauma" - skin flora
- DM, bites - Polymicrobial (gram -, anerobes)
- Puncture from plants - Fungal (sporotrichosis)
- Hematogenous spread
- Microbiology
- Gonorrhea
- Look for vesiculopustular skin lesion, polyarthralgia
- Mycobacteria
- Contiguous spread
Clinical Manifestations
- 4 Kanavel signs:
- (1) Finger held in slight flexion
- (2) Fusiform swelling
- (3) Tenderness along the flexor tendon sheath (late sign)
- (4) Pain with passive extension of the digit (early sign)
Diagnosis
- Xray
- Usually normal but helpful to r/o bony involvement, FB
- Blood culture
Treatment
- Surgery consult for wash-out versus debridement
- IV Abx (appropriate to the likely organism)