FLEXOR  TENOSYNOVITIS

1. Referred to as Flexor Tenosynovitis since  there is an infection along the sheet of the flexor tendon.
    
2. Infection commonly caused by Staph/Strep, Pseudomona introduced from biting injuries, puncture wound, etc.
    
3. On exam, finger  has: sausage  appearance, tenderness over the flexor tendon,  pain on passive extension, finger hold in flexion. These are the four signs of  Knavel.
    
4. Prompt antibiotic institution and STAT hand surgery consult for drainage in OR.   

De QUERVAIN'S  TENOSYNOVITIS

1. Pain in thumb area due to overuse and inflammation of extensor pollicis brevis and abductor pollicis.
2. Pain worsens when thumb closed into a fist, deviated ulnary (Finkelstein test).
    
3. Treatment c/w:
    
1. inject 1 ml of 0.5% bupivocaine + 40 mg (1 ml) triamcinolone into the sheath of above tendons
    
2. NSAIDs.
    
3. short-arm splint.

[BACK]