Photo Credit: John Kevin

The following is a summary of “High risk and low prevalence diseases: Flexor tenosynovitis,” published in the March 2024 issue of Emergency Medicine by Mehta, et al.

Flexor tenosynovitis (FTS) presents a significant challenge in the emergency department (ED) due to its potential for severe morbidity. For a study, researchers sought to outline the key aspects of FTS, including its presentation, diagnosis, and management, based on current evidence.

FTS commonly arises following penetrating trauma to the volar aspect of an upper extremity digit. It manifests as a deep space infection within the flexor tendon sheath, posing a risk for substantial hand damage and severe morbidity, including finger amputation or mortality. Clinical signs such as symmetrical finger swelling, flexed finger posture, pain on passive extension, and tenderness along the flexor tendon sheath, known as Kanavel signs, indicate FTS. Systemic symptoms like fever may also be present. Diagnosis relies primarily on clinical evaluation, as laboratory and imaging findings were often inconclusive. Prompt recognition is crucial, necessitating immediate intravenous antibiotics and consultation with surgical specialists in the ED.

A comprehensive understanding of FTS presentation and risk factors was vital for emergency clinicians to diagnose and manage the condition promptly, minimizing potential morbidity and optimizing patient outcomes.

Reference: sciencedirect.com/science/article/abs/pii/S0735675723007027