A 42-year-old female presents to the emergency department with complaints of worsening finger pain. She reports the pain started 2 days ago with redness at the tip of the finger. Over the past 24 hours, her redness has spread and the finger has become more painful. On arrival, she is afebrile and hemodynamically stable. She has the below exam findings with tenderness along the volar aspect of the finger and pain with passive extension (Figure 1). What is your suspected diagnosis? What is your initial workup? What is your management and disposition?
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- Chapman T, Ilyas AM. Pyogenic Flexor Tenosynovitis: Evaluation and Treatment Strategies. J Hand Microsurg. 2019;11(3):121-126. PMID: 31814662
- Hyatt BT, Bagg MR. Flexor Tenosynovitis. Orthopedic Clinics of North America. 2017;48(2):217-227. PMID: 28336044
- Hermena S, Tiwari V. Pyogenic Flexor Tenosynovitis. In: StatPearls. StatPearls Publishing; 2022. Accessed March 30, 2022. PMID: 35015439
- emDOCs.net – Emergency Medicine EducationEM in 5: Flexor Tenosynovitis – emDOCs.net – Emergency Medicine Education. Accessed April 20, 2022. http://www.emdocs.net/em-in-5-flexor-tenosynovitis/
- Ray G, Sandean DP, Tall MA. Tenosynovitis. In: StatPearls. StatPearls Publishing; 2022. Accessed March 31, 2022. PMID: 31335044.
- Bishop GB, Born T, Kakar S, Jawa A. The diagnostic accuracy of inflammatory blood markers for purulent flexor tenosynovitis. J Hand Surg Am. 2013;38(11):2208-2211. PMID: 24206985
- Jardin E, Delord M, Aubry S, Loisel F, Obert L. Usefulness of ultrasound for the diagnosis of pyogenic flexor tenosynovitis: A prospective single-center study of 57 cases. Hand Surg Rehabil. 2018;37(2):95-98. PMID: 29396150
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