26 year-old male presents with a swollen 4th digit and pain during extension, what’s the diagnosis?
Answer
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
Remember Kanavel's cardinal signs via mnemonic B.E.S.T. (the "BEST" mnemonic):
B: Bend finger (i.e., finger held in slight flexion)
E: Extension pain (i.e., pain on passive extension)
S: Sausage-like digit (i.e., fusiform swelling
T: Tenderness along tendon sheath
If early and not severe a course of IV antibiotics covering skin flora may be tried. Surgical intervention, however, is often necessary so early consultation with a hand surgeon is highly recommended
