Stenosing tenosynovitis

Trigger finger, also known as stenosing tenosynovitis, is a disorder characterized by catching or locking of the involved finger. Pain may occur in the palm of the hand or knuckles. The name is due to the popping sound made by the affected finger when moved. Most commonly the ring finger or thumb is affected. Trigger finger, also known as stenosing tenosynovitis, is a disorder characterized by catching or locking of the involved finger. Pain may occur in the palm of the hand or knuckles. The name is due to the popping sound made by the affected finger when moved. Most commonly the ring finger or thumb is affected. Risk factors include repeated injury, diabetes, kidney disease, thyroid disease, and inflammatory disease. The underlying mechanism involves the tendon sheath being too narrow for the flexor tendon. This typically occurs at the level of the A1 pulley. While often referred to as a type of stenosing tenosynovitis, little inflammation appears to be present. Diagnosis is typically based on symptoms after excluding other possible causes. Initial treatment is generally with rest, splinting the finger, NSAIDs, or steroid injections. If this is not effective surgery may be used. Trigger finger is relatively common. Females are affected more often than males. Those in their 50s and 60s are most commonly affected. The condition was formally described in 1850. Symptoms include catching or locking of the involved finger. As the disease progresses pain may occur in the palm of the hand or knuckles. In the ring and middle fingers, often a nodule can be felt at the area of the hand where the palm meets the finger. The cause of trigger finger is unclear but several causes have been proposed. It has also been called stenosing tenosynovitis (specifically digital tenosynovitis stenosans), but this may be a misnomer, as inflammation is not a predominant feature. It has been speculated that repetitive forceful use of a digit leads to narrowing of the fibrous digital sheath in which it runs, but there is little scientific data to support this theory. The relationship of trigger finger to work activities is debatable and scientific evidence for and against hand use as a cause exist. While the mechanism is unclear, there is some evidence that triggering of the thumb is more likely to occur following surgery for carpal tunnel syndrome. It may also occur in rheumatoid arthritis.