Flexor Tendinitis (Flexor Tenosynovitis)
Flexor tendinitis is the inflammation of the flexor tendon sheath, typically affecting the hand and fingers. It can be due to overuse, trauma, infection, or systemic conditions.
Etiology
- Repetitive hand use (e.g., typing, gripping tools)
- Acute trauma
- Inflammatory diseases (e.g., rheumatoid arthritis)
- Infection (see: Infectious flexor tenosynovitis)
Pathophysiology
- Inflammation of the synovial sheath surrounding the flexor tendons
- Thickening and impaired gliding of tendons
- May progress to fibrosis if untreated
Clinical Presentation
- Pain along the volar aspect of the finger or hand
- Swelling over the tendon sheath
- Stiffness, especially in the morning
- Pain with active/passive flexion
- Palpable crepitus (in some chronic cases)
Special Forms
- Trigger finger (stenosing tenosynovitis):
- A1 pulley involvement
- Locking or catching sensation during flexion
- Painful snapping or clicking
Diagnosis
- Clinical examination
- Ultrasound: tendon thickening, fluid in sheath
- MRI: helpful for chronic or unclear cases
Treatment Options
Treatment Type | Examples | Notes |
---|---|---|
Conservative | Rest, splinting, NSAIDs, physical therapy | First-line |
Injections | Corticosteroids (especially for trigger finger) | High success rate in early cases |
Surgery | Tenosynovectomy or pulley release | For refractory or advanced cases |
Prognosis
- Good with early treatment
- Risk of recurrence if overuse persists
- Trigger finger may progress if not treated