Trigger finger
Background
- Tenosynovitis of the flexor sheath of the finger or thumb as a result of repetitive use
- Also known as stenosing tenosynovitis
- Associated with:
- Diabetes
- Rheumatoid arthritis
- Amyloidosis
- Repetitive strain
- "Texting tendonitis"
Clinical Features
- Delayed, painful extension of digit
- Most commonly ring finger
- Finger clicking
- Palpable fibrous nodule
- Tenderness at A1 pulley (distal palm)
- Patients need to manually straighten finger with other hand
- Contrast with Dupuytren’s contracture, which is not usually associated with pain or history of repetitive overuse
Differential Diagnosis
Hand and finger injuries
- Distal finger
- Other finger/thumb
- Boutonniere deformity
- Mallet finger
- Jammed finger
- Jersey finger
- Trigger finger
- Ring avulsion injury
- De Quervain tenosynovitis
- Infiltrative tenosynovitis
- Metacarpophalangeal ulnar ligament rupture (Gamekeeper's thumb)
- Hand
- Wrist
- Drummer's wrist
- Ganglion cyst
- Lunotriquetral ligament instability
- Scaphoid fracture
- Extensor digitorum tenosynovitis
- Compressive neuropathy ("bracelet syndrome")
- Intersection syndrome
- Snapping Extensor Carpi Ulnaris
- Vaughn Jackson syndrome
- General
Evaluation
- Clinical diagnosis (radiographs not indicated)
Management
- Conservative therapy
- Rest
- NSAIDs
- Immobilization (buddy tape or finger splint)
- Refractory cases may require steroid injection or surgery
Disposition
- Outpatient management