- Trigger digit
- Locked finger
- Stenosing tenosynovitis
- 727.03 Trigger finger (acquired)
- M65.30 Trigger finger, unspecified finger
- Painful snapping or catching/locking of finger
- Inflammation of the fluid-filled sheath (tenosynovitis) surrounding
the flexor tendons of the phalanges
- Painful nodule at the distal flexion crease
- Inflammation causes interference with gliding of tendon at
the location of the A1 pulleys
- Thickening of sheath or tendon leads to constriction of
the sliding tendon, and nodules can develop.
- Crepitus and nodules may be palpable at location of A1 pulley.
- Cause is typically non-specific overuse.
- Pain with digit motion precedes triggering or locking sensations
- Pain may precede symptoms of triggering.
- Mechanical symptoms exacerbate condition, leading to increased
pain and decreased motion of the digit.
- Can be managed surgically or non-surgically depending upon
signs and symptom severity, response to conservative treatment,
and orthopedic physician recommendations.
- Unknown etiology, idiopathic
- Middle-aged women
- Increased incidence with diabetic population, young children,
and menopausal women.
- Associated in population with rheumatic disease/changes
in the hand.
- Pain in palmar metacarpophalangeal (MCP) joint region
with digit motion, especially flexion
- Nodule along the A1 pulley
- Palpable tenderness and possible swelling over palmar MCP
- Palpable crepitus over the palmar MCP joint
- Catching, locking, triggering with flexion of the digit
- Difficulty and or pain with opening and closing hand in
preparation for grasping or reaching
- Difficulty and/or pain with grasping dishes, utensils,
or drinking cups due to pain and weakness
- Difficulty and/or pain with grasping and turning
- Difficulty and/or pain with turning doorknob
- Rheumatoid arthritis, or other rheumatic or connective
- Diabetes mellitus
- Infection: M. Kansasii
- Carpal tunnel syndrome
- Psoriatic arthritis
- De Quervain’s stenosing tenosynovitis
- Overuse activity of the hand and fingers
- Rheumatoid arthritis
- Ganglion of tendon sheath
- Dupuytren disease
- Loose body in the MCP joint
- Subluxation of the extensor digitorum communis
- Diabetes mellitus
- No indication. Radiographs can be taken to rule out fracture.
- Start with a full fist, and then ask patient to open the
hand and extend the fingers.
- Corticosteroid injection into flexor sheath
- Surgical release possible after failed conservative care
- Radiologist for imaging, x-ray to rule out other pathology
- Primary care to rule our rheumatic causes ...
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