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Incidence and Extent of Tenosynovitis in Trigger Fingers
Mohini Rawat, DPT, ECS, RMSK; Mukund Patel, MD
NYU Langone Hand Surgery Brooklyn, New York, NY

Introduction: Trigger finger is also known as stenosing tenosynovitis of the flexor tendon, however there are some trigger finger cases without tenosynovitis. The purpose of this study is to find out percentage of trigger fingers with and without tenosynovitis and also to evaluate the extent of length of tenosynovitis through the use of ultrasonography. Materials & Methods: 200 cases of trigger finger were selected and examined with ultrasound for the presence or absence of tenosynovitis. Sonosite M-turbo was used for the sonographic evaluation of the flexor tendons in trigger finger cases. Exclusion criteria was presence of rheumatoid arthritis, gout, Diabetes, infection. Flexor tendon of the involved digit was examined using the ultrasound to look for presence or absence of tenosynovitis and extent of tenosynovitis from A1 pulley to A5 pulley.

Results: It was found that about 95.5 % of Trigger finger cases had tenosynovitis of the flexor tendon and the most commonly affected area was A1 pulley region. Within this group, in some cases (22 %) tenosynovitis extended from A1 to A2 pulley and in a very small percentage of the cases (1.5%) the entire tendon from A1 to A5 pulley showed presence of tenosynovitis. 4.5% of fingers had no evidence of any tenosynovitis. This group of patients had minimal or no tenderness at the distal palmar crease.

Conclusions: With this study we found that there is a small percentage of cases (4.5%) where there is no evidence of tenosynovitis based on sonographic examination, however the clinical presentation in this group was similar to other cases of trigger fingers with triggering but minimal tenderness at the distal palmar crease.

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