Flexor tenosynovitis - Revision history

Jonrako: /* Clinical Features */

2021-07-28T18:28:40Z

Clinical Features

← Older revision		Revision as of 18:28, 28 July 2021
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	*Uniform swelling (symmetric finger swelling along length of the tendon sheath)		*Uniform swelling (symmetric finger swelling along length of the tendon sheath)
	*Flexion posture (flexed posture of involved digit at rest to minimize pain)		*Flexion posture (flexed posture of involved digit at rest to minimize pain)

			[[File:Flexor Tenosynovitis.JPG\|thumb]]

			[[File:Flexor Tenosynovitis2.JPG\|thumb]]

	==Differential Diagnosis==		==Differential Diagnosis==

Hoxbox: /* Workup */

2020-12-08T12:38:29Z

Workup

← Older revision		Revision as of 12:38, 8 December 2020
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	*CBC		*CBC
	*ESR		*ESR
	*[[Ultrasound (Main)\|Ultrasound]]		*[[Ultrasound (Main)\|Ultrasound]]<ref>Ultrasound Probe: POCUS for Flexor Tenosynovitis from emDocs.net http://www.emdocs.net/ultrasound-probe-pocus-for-flexor-tenosynovitis/</ref>
	*Xray		*Xray

Lyssa1219: /* Evaluation */

2020-04-09T21:05:38Z

Evaluation

← Older revision		Revision as of 21:05, 9 April 2020
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	===Evaluation===		===Evaluation===
	*Generally a clinical diagnosis, based on history and physical exam		*Generally a clinical diagnosis, based on history and physical exam
			*Labs generally show elevated WBC and inflammatory markers
			*Xray is done to rule out radiopaque foreign body

	==Management==		==Management==
	*Emergent hand surgery consult in ED		*Emergent hand surgery consult in ED
	*[[Antibiotics]] (start immediately if suspected)		*[[Antibiotics for most common skin pathogens Strep and Staph]] (start immediately if suspected but consider obtaining wound culture if any spontaneous drainage is present)
	**[[Vancomycin]] 1gm IV q12hr '''AND'''		**[[Vancomycin]] 1gm IV q12hr '''AND'''
	**[[Ampicillin/Sulbactam]] 1.5gm IV q6h '''OR''' [[cefoxitin]] 2gm IV q8h '''OR''' [[Piperacillin/Tazobactam]] 3.375gm IV q6h		**[[Ampicillin/Sulbactam]] 1.5gm IV q6h '''OR''' [[cefoxitin]] 2gm IV q8h '''OR''' [[Piperacillin/Tazobactam]] 3.375gm IV q6h

			* [[Special Antibiotic Considerations]]
			** [[Diabetic Patients]] ensure you have Pseudomonal Coverage by using [[Piperacillin/Tazobactam]] rather than [[Ampicillin/Sulbactam]] or [[cefoxitin]]
			** [[Marine Exposure]] consider adding a [[Fluroquinolone]], [[Sulfamethoxazole/Trimethoprim]] or [[Doxycycline]] to cover common marine organisms

	==Disposition==		==Disposition==

Bobzmac: /* Evaluation */

2018-01-10T20:31:39Z

Evaluation

← Older revision		Revision as of 20:31, 10 January 2018
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	==Evaluation==		==Evaluation==
	[[File:FTS_Riscinti\|thumbnail\|Waterbath POCUS demonstrating fluid collection between tendon and bone<ref>http://www.thepocusatlas.com/musculoskeletal/</ref>]]		[[File:FTS_Riscinti.gif\|thumbnail\|Waterbath POCUS demonstrating fluid collection between tendon and bone<ref>http://www.thepocusatlas.com/musculoskeletal/</ref>]]
	===Workup===		===Workup===
	*CBC		*CBC

Bobzmac: /* Evaluation */

2018-01-10T20:31:14Z

Evaluation

← Older revision		Revision as of 20:31, 10 January 2018
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	==Evaluation==		==Evaluation==
			[[File:FTS_Riscinti\|thumbnail\|Waterbath POCUS demonstrating fluid collection between tendon and bone<ref>http://www.thepocusatlas.com/musculoskeletal/</ref>]]
	===Workup===		===Workup===
	*CBC		*CBC

Mholtz at 06:31, 7 July 2017

2017-07-07T06:31:50Z

← Older revision		Revision as of 06:31, 7 July 2017
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	==Clinical Features==		==Clinical Features==
	===Kanavel's Signs===		===Kanavel's Signs===
	#Pain with passive extension		*Pain with passive extension (often the first sign seen)
	~~#*Often~~ the first sign seen		*Percussion tenderness (tenderness over entire length of flexor tendon sheath)
	#Percussion tenderness		*Uniform swelling (symmetric finger swelling along length of the tendon sheath)
	~~#*Tenderness~~ over entire length of flexor tendon sheath		*Flexion posture (flexed posture of involved digit at rest to minimize pain)
	#Uniform swelling
	~~#*Symmetric~~ finger swelling along length of the tendon sheath
	#Flexion posture
	~~#*Flexed~~ posture of involved digit at rest to minimize pain

	==Differential Diagnosis==		==Differential Diagnosis==
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	===Evaluation===		===Evaluation===
	*Generally a clinical ~~evaluation~~, based on history and physical exam		*Generally a clinical diagnosis, based on history and physical exam

	==Management==		==Management==
	*Emergent ~~ortho (~~hand) consult in ED		*Emergent hand surgery consult in ED
	*[[Antibiotics]] (start immediately if suspected)		*[[Antibiotics]] (start immediately if suspected)
	**[[Vancomycin]] 1gm IV q12hr '''~~PLUS~~'''		**[[Vancomycin]] 1gm IV q12hr '''AND'''
	**[[Ampicillin/Sulbactam]] 1.5gm IV q6h '''OR''' [[cefoxitin]] 2gm IV q8h '''OR''' [[Piperacillin/Tazobactam]] 3.375gm IV q6h		**[[Ampicillin/Sulbactam]] 1.5gm IV q6h '''OR''' [[cefoxitin]] 2gm IV q8h '''OR''' [[Piperacillin/Tazobactam]] 3.375gm IV q6h

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	==References==		==References==
	<References/>		<References/>


	[[Category:ID]]		[[Category:ID]]
	[[Category:Orthopedics]]		[[Category:Orthopedics]]

Neil.m.young: Text replacement - "==Diagnosis==" to "==Evaluation=="

2016-07-22T04:56:13Z

Text replacement - "==Diagnosis==" to "==Evaluation=="

← Older revision		Revision as of 04:56, 22 July 2016
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	{{Template:Hand Infection DDX}}		{{Template:Hand Infection DDX}}

	==~~Diagnosis~~==		==Evaluation==
	===Workup===		===Workup===
	*CBC		*CBC

Neil.m.young: Text replacement - " w/ " to " with "

2016-07-11T15:47:44Z

Text replacement - " w/ " to " with "

← Older revision		Revision as of 15:47, 11 July 2016
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	==Background==		==Background==
	*Surgical emergency - flexor sheaths are contiguous w/ deep spaces of the hand		*Surgical emergency - flexor sheaths are contiguous with deep spaces of the hand
	*Usually associated with a penetrating trauma		*Usually associated with a penetrating trauma

	==Clinical Features==		==Clinical Features==
	===Kanavel's Signs===		===Kanavel's Signs===
	#Pain w/ passive extension		#Pain with passive extension
	#*Often the first sign seen		#*Often the first sign seen
	#Percussion tenderness		#Percussion tenderness

Ostermayer: Text replacement - "Category:Ortho" to "Category:Orthopedics"

2016-03-22T15:47:56Z

Text replacement - "Category:Ortho" to "Category:Orthopedics"

← Older revision		Revision as of 15:47, 22 March 2016
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	[[Category:ID]]		[[Category:ID]]
	[[Category:~~Ortho~~]]		[[Category:Orthopedics]]

Rossdonaldson1: /* External Links */

2015-10-31T17:13:54Z

External Links

← Older revision		Revision as of 17:13, 31 October 2015
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	==External Links==		==External Links==

			==Video==
			{{#widget:YouTube\|id=4oCzzvTiwew}}

	==References==		==References==