UMEM Educational Pearls

Category: Orthopedics

Title: Flexor Tenosynovitis

Keywords: Flexor, Tenosynovitis (PubMed Search)

Posted: 1/21/2012 by Michael Bond, MD
Click here to contact Michael Bond, MD

Flexor Tenosynovitis

  • This is a rapidly spreading infection of the finger and hand.
  • Often starts as an infection in the finger that then spreads into the hand due to the flexor sheaths.
  • The flexor tendon sheaths of the long, index, and ring finger extend from the distal phalanx to the superficial palmar arch, and some even extend to the wrist.
  • Most patient will need to be admitted for IV antibiotics and a hand consult for probable operative I&D
  • You can diagnosis flexor tenosynovitis by documenting the four Kanavel signs:
    1. Fusiform swelling of the finger
    2. Finger held in partial flexion (position of comfort)
    3. Percussion tenderness along the flexor tendon
    4. Increased pain with passive extension of the finger

You can follow this link, http://www.youtube.com/watch?v=qf9SW0ChsCU  , to see the physical exam findings of flexor tenosynovitis