II. Pathophysiology
- Swelling of flexor tendon and sheath
- Difficult passage of swollen tendon through pulley
- Analogous to knotted fishing line in pole eyes
- Congenital form seen in some children
III. Findings: Signs and symptoms
- Snapping or triggering of affected finger at MCP joint
- Worse after rest
- Improves with active finger use
- Triggering transmitted to DIP joint
- Entire finger may lock
- Proximal flexor pulley swelling
- Tenderness to palpation
- Swollen, firm mass palpable at pulley
IV. Differential Diagnosis
-
Suppurative Tenosynovitis
- Severe, finger-threatening infection that rapidly spreads along the flexor surface of the finger
V. Management
- Similar approach as for De Quervain's Tenosynovitis
- NSAIDs
- Immobilization
- Avoid offending activity
- Moist heat as needed
- Digital Flexor Tenosynovitis Injection
- Surgical correction if refractory to above management