Flexor tendon “catches” as it attempts to glide through a stenotic flexor tendon sheath
Initially, patient's report painless catching or locking of the affected digit during flexion
During finger flexion and extension, pain is caused by inflamed tendon passing through a relatively constricted tendon sheath
Occurs most often in the ring and middle digits
May improve over the course of the day
Diagnoses with active triggering (with digit flexion and extension) and tenderness to palpation at the first annular pulley (A1) which overlies the first MCP joint
-Ask patient to place hand on table face up and gradually fully flex and extend the fingers
May note a palpable nodule of the flexor tendon
Treatment: Activity modification, NSAIDs and splinting (3-6 weeks)
