What is flexor tenosynovitis?

Flexor tenosynovitis is a medical condition in which one or more tendons in the hand become inflamed, painful, and stiff. An affected finger may swell at the base and spontaneously lock and release from a fixed position. The disorder may arise due to infection, frequent overuse of a finger joint, or a complication of rheumatoid arthritis. Treatment for flexor tenosynovitis depends on the underlying cause, but most cases can be relieved by taking anti-inflammatory medications and antibiotics. Surgery may be necessary in severe cases to manually release the tension built up in the flexor tendons.

The hand contains various tendons that connect bone, muscle, and cartilage tissue. Each flexor tendon in the fingers and palm is lined with a fluid-filled sheath that provides protection and lubrication, allowing the finger joints to bend easily. In the case of flexor tenosynovitis, the sheath becomes inflamed, fluid accumulates, and the joint becomes difficult or impossible to use comfortably. Any tendon can be affected, but the condition occurs most often in the thumb and ring finger.

Many different bacteria and viruses can cause flexor tenosynovitis. Most cases are the result of direct infections that occur with deep puncture wounds, animal bites, or severe cuts. Flexor tenosynovitis can also arise as a chronic overuse injury, similar to tendonitis in larger body joints. Also, some people experience stiff finger joints and tenosynovitis as symptoms of rheumatoid arthritis.

A person suffering from flexor tenosynovitis may experience a number of physical symptoms. The most telltale sign of the condition is called trigger finger, which refers to the tendency of a finger to suddenly lock in a bent position and then just as abruptly relax again. A joint may swell and feel tender to the touch. As flexor tenosynovitis progresses, a finger's range of motion may be severely limited, and pain may begin to radiate through the hand and forearm.

A person experiencing acute or chronic finger pain should make an appointment with a doctor immediately. A doctor can usually diagnose the condition by performing a complete physical exam and taking diagnostic images of the hand. An MRI scan may reveal clinical signs of flexor tenosynovitis, including fluid buildup and swelling in the tendon sheath. If the doctor suspects an infection, he or she may collect a blood sample to test for specific pathogens.

After making a diagnosis, the doctor can determine the best course of treatment. Immediate symptoms of pain and swelling are usually managed with oral medications or corticosteroid injections. A patient may receive antibiotics on a present infection. If the problems are not relieved with medication, a surgeon may need to puncture the tendon to drain excess fluid. Another procedure called a tendon release may be done to stretch and relax the affected tendon. After receiving treatment, the patient is usually instructed to do light stretching exercises to regain strength and flexibility over the course of several months.

Go up