Clinical Presentation
- More commonly presents in the 3rd and 4th hand digit, less commonly the thumb
- Produces a painful clicking as the inflamed tendon glides (by finger flexion and extension) through the thickened and stenosed sheath
- The digit may "lock" in flexion, extension, or in the middle range
- Determine if there is normal passive range of motion in the MP, PIP, and DIP joints (with true triggering there should be locking as the digit is passively taken thru a ROM)
- With chronic triggering, a proximal intrphalangeal flexion contracture (or interphalangeal flexion joint contracture) may develop
- Palpation may reveal a mobile, often tender, nodule within a tendon sheath of a finger or palm (which may imply a better prognosis with nonoperative treatment)
- Determine if the patient can flex and extend the digit past the triggering point without assistance
Read more about this topic: Stenosing Tenosynovitis
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