UMEM Educational Pearls


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

Follow me on Twitter (@criticalcarenow) or Google+ (+haney mallemat)