- Discussion:
- for diagnosing
infectious tenosynovitis;
-
intense pain accompanies any attempt to extend partly flexed finger;
- this is absent in local involvement;
- pain will be noted along the course of tendon with extension;
- this is the earliest and most important sign;
- in case of a local furuncle, in contrast, the finger can be held
straight without much pain;
-
flexion posture: finger is held in flexion for comfort;
-
uniform swelling involving entire finger in contrast to localized swelling in local inflammation;
-
percussion tenderness along the course of the tendon sheath;
- tenderness is marked along the course of inflammed sheath in contrast
to its absence in a localized inflammation;
- Diff Dx:
- beware that a
mid palmar space abscess may elicit pain w/ attempted passive motion of the ring and long fingers;
- localized bleeding into the tendon sheath may occur in patients on coumadin, and this will give the
exact appearance of infectious tenosynovitis;
