Finger flexor tenosynovitis most often
presents as a stenosing tenosynovitis, or trigger finger. Dramatic proliferative
tenosynovitis is uncommon, and should raise the suspicion of an infectious
process. In this setting, steroid injection should be avoided because of
the chance of precipitating a catastrophic septic diathesis. Rheumatologic
evaluation is indicated, and if nondiagnostic, synovectomy with intraoperative
cultures should be performed. This was the situation in the case of this
patient. |