Pyogenic Flexor Tenosynovitis



50-year-old man, kidney transplant, with post-transplant diabetes. Inpatient for pneumonia. It evolves with delirium, so it requires physical containment with mitt-type gloves. The next day, he complains of pain in his fingers. On physical examination, fusiform swelling, tenderness along the palmar aspect of the finger and pain with passive extension are noted



The patient met 3 of the 4 Kanavel criteria for pyogenic flexor tenosynovitis of the hand : fusiform swelling, tenderness in the tendon, pain with passive extension and finger in slight flexion. MRI confirmed the diagnosis and traumatology was consulted for debridement. He underwent an urgent amputation. Early recognition of pyogenic flexor tenosynovitis is important as it behaves as an abscess and can extend into the arm through the compartments of the hand.



#Flexor #Tenosynovitis #Hand #Finger #Clinical #Photo