Infectious tenosynovitis is an infection of a tendon and its protective sheath. This infection is most common in the finger, hand, or wrist. It can be quite serious. Quick treatment can help prevent permanent damage to tissues.
What infections cause tenosynovitis?
What causes infectious tenosynovitis?
- Staphylococcus aureus – Most commonly isolated bacteria, associated with ~80% of infections.
- Streptococcus species – Second most commonly isolated bacteria.
- Pasteurella multocida – High index of suspicion if the infection develops within 24 hours after a cat bite.
Can you get an infection from tendonitis?
Infection and pus form around the tendon and rapidly destroy tissue. The gliding mechanism of the tendon becomes damaged, so the finger can barely move. Symptoms of infection of the tendon sheath include swelling and pain of the finger and tenderness over the tendon sheath.
What is infectious flexor tenosynovitis?
Infectious flexor tenosynovitis is an acute infection within the flexor tendon sheath. Diagnosis is suggested by Kanavel signs and confirmed with x-rays. Treatment is surgical drainage and antibiotics.
Is infectious flexor tenosynovitis an emergency?
Urgent message: Infectious flexor tenosynovitis is an orthopedic emergency that can cause long-lasting disability through tendon necrosis and permanent digital contracture if unrecognized or mismanaged.
How do you treat infectious flexor tenosynovitis?
Treatment of infectious flexor tenosynovitis is surgical drainage (eg, irrigation of the tendon sheath by inserting a cannula into one end and allowing the irrigating fluid to pass along the tendon sheath to the other end, or an extensive open incision for more serious infections).
What are kanavel signs?
The Kanavel cardinal signs of flexor sheath infection are a finger held in slight flexion, fusiform swelling of the affected digit, tenderness along the flexor tendon sheath, and pain with passive extension of the digit. A suspicion of flexor sheath infection warrants urgent referral to a hand unit.
Is tenosynovitis an autoimmune disease?
The term inflammatory tenosynovitis, in this context, refers to a noninfectious inflammatory process within the space of the tendon sheath. This can be secondary to autoimmune disorders (eg, RA and psoriatic arthritis) or crystalline deposition disorders (eg, gout, CPPD [pseudogout], and amyloidosis).
How is infectious tenosynovitis diagnosed?
Diagnosis of Infectious Flexor Tenosynovitis Flexed resting position of the digit. Fusiform swelling. Tenderness along the flexor tendon sheath. Pain with passive extension of the digit.
What is septic tenosynovitis?
Septic tenosynovitis was defined as the presence of at least two of the following Kanavel signs13 on concomitant assessment by one resident (in training) physician and one attending hand surgeon: (1) slight flexion of the affected digits; (2) fusiform swelling over the affected tendon; (3) tenderness over the affected …
Does flexor tenosynovitis trigger finger?
Trigger finger (also called stenosing flexor tenosynovitis) is caused by a disparity in the size of the flexor tendons and the surrounding retinacular pulley system at the first annular (A1) pulley (figure 1) which overlies the metacarpophalangeal (MCP) joint (figure 2).
How is suppurative tenosynovitis treated?
If PFT is detected within 48 hours, nonsurgical management with intravenous antibiotics and elevation of the hand may be appropriate. The affected hand should be closely monitored. If no improvement or worsening symptoms are detected after 24 hours, surgical intervention is necessary.
What are flexor tendon injuries?
Most commonly, a flexor tendon injury results from lacerations (cuts). A laceration to the forearm, hand or wrist can result in injury to the flexor tendons. When a flexor tendon injury happens there can be inability to bend the fingers, thumb or wrist.
Is tenosynovitis an infection?
Infections around the tendons of the finger can be very serious. These are called flexor tenosynovitis, or a flexor tendon sheath infection. Prior to our understanding of the importance of surgery and the discovery of antibiotic treatment, flexor tenosynovitis often led to loss of limb or death. 1 Today, these infections can be treated.
What is flexor synovitis?
Flexor tenosynovitis (FT), also called flexor tendon synovitis or flexor synovitis, refers to the inflammation of the synovial sheath and tendons of the finger joints of the hands. It is usually caused by infection, but acute and chronic inflammatory pathophysiologic states, such as arthritis and diabetes, may also cause this condition.
