What are the causes and symptoms of tenosynovitis

Nowadays, people seldom write with their hands, because after everyone has computers and mobile phones, these two electronic products are their daily means of communication, so it is not important whether they write or not. However, many people will still suffer from tenosynovitis even if they do not write for a long time. Logically, their hand functions can get a good rest, but this disease is also called stenosing tenosynovitis or trigger finger, a common hand surgical disease. Patients will feel joint soreness, numbness, swelling and pain. In more serious cases, they will hear the sound of brittle bones rubbing against each other at the fingertips during joint movement. This mainly includes two factors: congenital complications and acquired joint strain. Failure to pay attention to the proper protection of joints for a long time will lead to the occurrence of this disease. In normal times, you should choose the appropriate method of treatment according to the symptoms.

1. Overview

Finger flexor tenosynovitis, also known as stenosing tenosynovitis or trigger finger, is one of the most common hand surgical diseases. Its main manifestation is that patients feel soreness and pain on the palm side of the metacarpophalangeal joint during flexion and extension of the fingers. In severe cases, there will be snapping or even locking, leading to flexion and extension dysfunction of the fingers. Although this disease can affect both adults and children, its causes and treatments are different.

2. Causes

Finger flexor tenosynovitis in children is also called congenital stenosing tenosynovitis. It is caused by abnormal thickening of the A1 tendon sheath, which leads to stenosis of the sheath. The flexor tendon forms a nodule-like enlargement at the proximal end of the A1 tendon sheath, thus causing flexion and extension dysfunction of the fingers. However, there is controversy as to whether the cause of the disease is congenital or acquired.

The cause of finger flexor tenosynovitis in adults is more related to strain of the affected finger. Due to repeated flexion and extension of the affected finger in a short period of time, aseptic inflammatory changes occur in the tendon sheath tissue, which eventually leads to thickening of the tendon sheath and stenosis of the sheath. On the other hand, due to strain or changes in hormone levels in women (pregnancy or menstruation), the finger flexor tendons swell, and the volume of the tendon sheath is limited, so it can also form stenosis and compression relative to the swollen tendon.

In addition to the above-mentioned causes, there are some aggravating factors of the disease, such as cold stimulation, diabetic patients, peritendinous synovitis, rheumatoid patients, etc.

3. Clinical manifestations

The early symptoms of finger flexor tenosynovitis are soreness, swelling and pain on the palm side of the metacarpophalangeal joint during flexion and extension of the fingers. In more severe cases, snapping or even locking may occur, leading to flexion and extension dysfunction of the fingers. These symptoms are more severe in the morning when getting up, and some symptoms are alleviated in the afternoon. Cold stimulation can often aggravate the symptoms. Finger flexor tenosynovitis in children often affects the thumb, while in adults all fingers can be affected. Physical examination may reveal tenderness at the level of the A1 pulley. In some patients, a nodule-like swelling may be felt near the A1 pulley, and the swelling may slide back and forth with the flexor tendon when the fingers are flexed and extended. In more severe cases, the affected finger may present with a fixed flexion deformity (locking), and both active and passive extension may be limited.

4. Inspection

Finger flexor tenosynovitis can generally be diagnosed through clinical examination. For less typical cases, B-ultrasound examination can be used for diagnosis. Although magnetic resonance imaging has a high sensitivity, it is still not suitable as the preferred auxiliary examination considering its high price.

5. Diagnosis

Usually, the diagnosis can be easily established with a clear history of strain and progressive soreness, pain, snapping, and locking of the fingers. For atypical cases, B-ultrasound examination can also be performed to assist in diagnosis.