26 year old male with pain when he extends his 4th finger as well as swelling of that digit. Diagnosis?
Answer: Infectious Flexor Tenosynovitis
Infectious Flexor Tenosynovitis
- Closed space infection of the flexor tendon sheath; an orthopedic emergency
- Typically an infection with skin flora secondary to penetrating trauma
- Diagnosed by Kanavel's Signs:
- Finger held in slight flexion
- Fusiform swelling
- Pain on passive extension
- Pain while palpating the tendon sheath
- If early and not severe a course of IV antibiotics (covering skin flora) may be tried, however, surgical intervention is often necessary; early consultation with a hand surgeon is highly recommended
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