Flexor tenosynovitis: Difference between revisions
m (Rossdonaldson1 moved page Flexor Tenosynovitis to Flexor tenosynovitis) |
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*Kanavel's Signs: | *Kanavel's Signs: | ||
#Percussion tenderness | #Percussion tenderness | ||
# | #*Tenderness over entire length of flexor tendon sheath | ||
#Uniform swelling | #Uniform swelling | ||
# | #*Symmetric finger swelling along length of the tendon sheath | ||
#Pain w/ passive extension | #Pain w/ passive extension | ||
#*Often the first sign seen | |||
#Flexion posture | #Flexion posture | ||
# | #*Flexed posture of involved digit at rest to minimize pain | ||
==DDX== | ==DDX== | ||
Revision as of 02:24, 23 February 2015
Background
- Surgical emergency; flexor sheaths are contiguous w/ deep spaces of the hand
- Usually associated with penetrating trauma
Clinical Features
- Kanavel's Signs:
- Percussion tenderness
- Tenderness over entire length of flexor tendon sheath
- Uniform swelling
- Symmetric finger swelling along length of the tendon sheath
- Pain w/ passive extension
- Often the first sign seen
- Flexion posture
- Flexed posture of involved digit at rest to minimize pain
DDX
Hand and finger infections
- Bed bugs
- Closed fist infection (Fight Bite)
- Hand cellulitis
- Hand deep space infection
- Hand-foot-and-mouth disease
- Herpetic whitlow
- Felon
- Flexor tenosynovitis
- Paronychia
- Scabies
- Sporotrichosis
Look-Alikes
Treatment
- Antibiotics
- Start immediately
- Vancomycin 1gm IV q12hr + (Ampicillin/Sulbactam 1.5gm IV q6h OR cefoxitin 2gm IV q8h OR Piperacillin/Tazobactam 3.375gm IV q6h)
- Consult hand surgery in the ED
See Also
Source
- Tintinalli