II. Pathophysiology

  1. Swelling of flexor tendon and sheath
    1. Difficult passage of swollen tendon through pulley
    2. Analogous to knotted fishing line in pole eyes
  2. Congenital form seen in some children

III. Signs and symptoms

  1. Snapping or triggering of affected finger at MCP joint
    1. Worse after rest
    2. Improves with active finger use
  2. Triggering transmitted to DIP joint
    1. Entire finger may lock
  3. Proximal flexor pulley swelling
    1. Tenderness to palpation
    2. Swollen, firm mass palpable at pulley

IV. Management

  1. Similar approach as for De Quervain's Tenosynovitis
  2. NSAIDs
  3. Immobilization
  4. Avoid offending activity
  5. Moist heat as needed
  6. Digital Flexor Tenosynovitis Injection
  7. Surgical correction if refractory to above management

Images: Related links to external sites (from Google)

Ontology: Tenosynovitis (C0039520)

Definition (MSH) Inflammation of the synovial lining of a tendon sheath. Causes include trauma, tendon stress, bacterial disease (gonorrhea, tuberculosis), rheumatic disease, and gout. Common sites are the hand, wrist, shoulder capsule, hip capsule, hamstring muscles, and Achilles tendon. The tendon sheaths become inflamed and painful, and accumulate fluid. Joint mobility is usually reduced.
Concepts Disease or Syndrome (T047)
MSH D013717
SnomedCT 240035004, 67801009, 156666009, 268092005
English Tenosynovitides, Tenosynovitis, TENOSYNOVITIS, Tenosynovitis, NOS, tenosynovitis (diagnosis), tenosynovitis, Tenosynovitis [Disease/Finding], Inflammation of the tendon sheath, tendinous synovitis, tendovaginitis, tenovaginitis, Inflammation of tendon sheath, Tendinous synovitis, Tendovaginitis, Tenontolemmitis, Tenosynovitis (disorder), Tenovaginitis, Vaginal synovitis, Peritendinitis, peritendinitis, Tenosynovitis NOS
French TENOSYNOVITE, Péritendinite, Tendovaginite, Ténosynovite
Spanish TENOSINOVITIS, Peritendinitis, Tendovaginitis, Tenosynovitis, Inflammation of tendon sheath, tenosinovitis, tendosinovitis (trastorno), tendosinovitis, tenosinovitis (trastorno), sinovitis tendinosa, sinovitis vaginal, tendovaginitis, tenovaginitis, Tenosinovitis
Dutch peritendinitis, tendovaginitis, tenosynovitis, Synovitis, teno-, Tenosynovitis
German Peritendinitis, Tendosynovitis, Tenosynoviitis, Tenosynovitis, TENDOSYNOVITIS, Tendovaginitis, Sehnenscheidenentzündung
Italian Peritendinite, Tendovaginite, Tenosinovite
Portuguese Peritendinite, Tendovaginite, TENOSINOVITE, Tendossinovite, Tenossinovite
Japanese 腱鞘炎, 腱周囲炎, ケンショウエン, ケンシュウイエン
Swedish Senskideinflammation
Czech tenosynovitida, Tendosynovitida, Peritendinitida, Tendovaginitida
Finnish Jännetuppitulehdus
Russian TENDOVAGINIT, TENOSINOVIT, ТЕНДОВАГИНИТ, ТЕНОСИНОВИТ
Polish Zapalenie pochewki ścięgna
Hungarian Peritendinitis, Tendovaginitis, Tenosynovitis

Ontology: Trigger Finger Disorder (C0158328)

Definition (NCI) A painful hand deformity affecting the fingers. It is due to damage of the finger flexor tendons, causing the finger to remain in a locked position.
Definition (MSH) A painful disability in the hand affecting the finger or thumb. It is caused by mechanical impingement of the digital flexor tendons as they pass through a narrowed retinacular pulley at the level of the metacarpal head. Thickening of the sheath and fibrocartilaginous metaplasia can occur, and nodules can form. (From Green's Operative Hand Surgery, 5th ed, p2137-58).
Concepts Acquired Abnormality (T020)
MSH D052582
ICD9 727.03
ICD10 M65.3
SnomedCT 1539003, 156671002, 202904003, 268095007
English TRIGGER FINGER, Trigger finger (acquired), Nodular tendin dis of finger, Snapping finger, Digit, Trigger, Digits, Trigger, Entrapment, Flexor Tendon, Entrapments, Flexor Tendon, Finger, Snapping, Fingers, Snapping, Flexor Tendon Entrapments, Flexor Tendon Entrapment, Snapping Fingers, Tendon Entrapment, Flexor, Tendon Entrapments, Flexor, Trigger Digits, Trigger Digit, Snapping Finger, Trigger finger - acquired, acquired trigger finger (diagnosis), trigger finger, acquired trigger finger, trigger finger (physical finding), trigger finger (acquired), Trigger Finger Disorder [Disease/Finding], finger trigger, finger triggered, snapping finger, fingers trigger, snap finger, Trigger Finger Disorder, Trigger finger, Acquired trigger finger, Nodular tendinous disease of finger, Triggering of finger, Acquired trigger finger (disorder), finger; snapping, snapping; finger, Finger snapping, Finger trigger, Snapping fingers
Italian Dito a scatto, Dito a scatto (acquisito), Disturbo del dito a scatto, Difficoltà di scorrimento del tendine flessore, Dita a scatto
Dutch trigger finger of hokkende vinger (verworven), finger; snapping, snapping; finger, Trigger finger, trigger finger of hokkende vinger
French Doigt à ressort (acquis), Doigt à ressaut, Doigt à ressort, Doigt en gachette
German Trigger-Finger (erworben), Schnellender Finger, Digitus saltans, Schnappfinger, Springender Finger, Tendovaginitis stenosans, Trigger-Finger
Portuguese Dedo em gatilho (adquirido), Encarceramento do Tendão Flexor, Dedo em Gatilho, Transtorno do Dedo em Gatilho, Aprisionamento do Tendão Flexor, Compressão do Tendão Flexor, Dedo em mola
Spanish Dedo en resorte (adquirido), Atrapamiento del Tendón Flexor, Atrapamiento del Tendon Flexor, Trastorno del Dedo en Gatillo, Trigger finger, Snapping finger, Snapping fingers, Trigger finger - acquired, Finger snapping, Finger trigger, dedo de la mano en gatillo adquirido, dedo de la mano en gatillo adquirido (trastorno), dedo en resorte adquirido (trastorno), dedo en resorte adquirido, enfermedad tendinosa nodular de dedo de la mano, Dedo en gatillo
Russian "ЗАЩЕЛКИВАЮЩИЕСЯ ПАЛЬЦЫ", "ПРУЖИНЯЩИЕ ПАЛЬЦЫ", TRIGGER FINGER РАССТРОЙСТВО, СВЯЗКОСГИБАТЕЛЯ УЩЕМЛЕНИЕ, ЛИГАМЕНТИТ СТЕНОЗИРУЮЩИЙ КОЛЬЦЕВИДНОЙ СВЯЗКИ, "ЩЕЛКАЮЩИЙ ПАЛЕЦ", "SHCHELKAIUSHCHII PALETS", TRIGGER FINGER RASSTROISTVO, "PRUZHINIASHCHIE PAL'TSY", LIGAMENTIT STENOZIRUIUSHCHII KOL'TSEVIDNOI SVIAZKI, "ZASHCHELKIVAIUSHCHIESIA PAL'TSY", SVIAZKOSGIBATELIA USHCHEMLENIE
Japanese 弾発指(後天性), ダンパツシ, ダンパツシコウテンセイ, ばね指, バネ指, 弾発指, 弾撥指
Finnish Napsusormihäiriö
Czech skákavé prsty, skákavý prst, lupavý prst, Lupavý prst (získaný), Lupavý prst
Swedish Triggertumme
Korean 방아쇠 손가락증
Polish Palec przeskakujący, Palec trzaskający
Hungarian Pattanó ujj, Pattanó ujj (szerzett)