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Question
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
References
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