SlideShare a Scribd company logo
TRIGGER FINGER
PRESENTED BY: DR. ZUNAIRA AHMAD
DEFINITION
• Inflammation and subsequent narrowing of pulley of
affected digit (most commonlyA1) Typically 3rd, 4th digit
• [Annular (A1-A5) ligaments of the tendon sheath
over the flexor tendons]
• Flexor tendon / tendon sheath thickens
• The main characteristic of trigger finger is popping and
/ or catching with movement of the digit especially at
bending.
CLINICAL PRESENTATION
• Initially, patients may present with painless clicking during movement of the digit. This can progress to
painful catching or popping, typically at the MCP or PIP joints.
• Possible additional symptoms are:
• Stiffness and swelling (especially in the morning)
• Intermittent finger locking during active flexion that requires a passive force to extend the finger
• Finger locking or clicking in a bent position then popping straight
• Loss of full flexion / extension
• Palpable painful nodule proximal to A1, and / or finger locked into a flexed position
DIFFERENTIAL DIAGNOSIS
• Dupuytren's contracture
• Flexor tendon / sheath tumor.
• Sesamoid bone anomalies
• Post-traumatic tendon entrapment on the metacarpal head
• History
• Past Medical History
 Diabetic individuals are four times more likely to develop trigger finger
 RA and Gout are also associated with trigger finger
• Observation
 A digit locked in flexion
 Bony proliferative changes in the sub-adjacent PIP joint
• Palpation
• Range of Movement (Loss of motion, particularly in extension)
• Manual Muscle Testing
• Joint Accessory Mobility (PIP, MCP, DIP, and CMC of all affected digits)
• Special Tests (Open and Close hand)
EXAMINATION
Physiotherapy
1. Rest
2. Splinting
 6-10 weeks
 2 types
 At DIP joint (50% resolution of symptoms)
 At MCP joint with 15 degrees of flexion. (92.9% resolution)
3. Exercises
 AROM ( abduction, Adduction to strengthen interossei and
the lumbricals)
 Digital blocking
 Tendon glide exercise
 Duck
 Hook
 Squeeze
 Touch and Trace
 Spread wide
MANAGEMENT
4 Hot/cold
5 Massage
6 Ultrasound
7 Electrical stimulation
8 Passive therapeutic
traction
9 Extracorporeal
Shockwave Therapy
 Operative
Trigger finger/ Stenosing tenosynovitis

More Related Content

What's hot

Recurrent Dislocation of patella -PAWAN
Recurrent Dislocation of patella -PAWANRecurrent Dislocation of patella -PAWAN
Recurrent Dislocation of patella -PAWAN
Pawan Yadav
 
Mallet finger
Mallet fingerMallet finger
Mallet finger
Muhammad Abdelghani
 
PRINCIPLES OF TENDON TRANSFERS
PRINCIPLES OF TENDON TRANSFERSPRINCIPLES OF TENDON TRANSFERS
PRINCIPLES OF TENDON TRANSFERS
Benthungo Tungoe
 
Sprengel’s shoulder
Sprengel’s shoulderSprengel’s shoulder
Sprengel’s shoulder
kajal sansoya
 
radial nerve palsy
radial nerve palsy radial nerve palsy
radial nerve palsy
Sumer Yadav
 
Radial club hand (Radial Dysplasia)
Radial club hand (Radial Dysplasia)Radial club hand (Radial Dysplasia)
Radial club hand (Radial Dysplasia)
Aiman Ali
 
Genu varum, Genu valgum, Genu recurvatum
Genu varum, Genu valgum, Genu recurvatumGenu varum, Genu valgum, Genu recurvatum
Genu varum, Genu valgum, Genu recurvatum
Murugesh M Kurani
 
Mallet finger
Mallet fingerMallet finger
Mallet finger
Santosh Batajoo
 
De quervain's
De quervain'sDe quervain's
De quervain's
Lee Yew
 
Morton Neuroma
Morton Neuroma Morton Neuroma
Morton Neuroma
Ade Wijaya
 
Foot drop
Foot dropFoot drop
Foot drop
Supraja Avula
 
Radial nerve injury
Radial nerve injuryRadial nerve injury
Radial nerve injury
EuniceSusan
 
Shoulder Instability
Shoulder InstabilityShoulder Instability
Shoulder Instability
Atif Shahzad
 
Tarsal tunnel syndrome
Tarsal tunnel syndromeTarsal tunnel syndrome
Tarsal tunnel syndrome
Prashanth Kumar
 
Lateral epicondylitis
Lateral epicondylitisLateral epicondylitis
Lateral epicondylitis
Nithyalaksmi Rajesh
 
Median nerve injuries and mangement
Median nerve injuries and mangementMedian nerve injuries and mangement
Median nerve injuries and mangement
sanyal1981
 
Tennis elbow
Tennis elbowTennis elbow
Tennis elbow
Subin Sabu
 
Reflex Sympathetic Dystrophy (CRPS 1)
Reflex Sympathetic Dystrophy (CRPS 1)Reflex Sympathetic Dystrophy (CRPS 1)
Reflex Sympathetic Dystrophy (CRPS 1)Sayantika Dhar
 
Median nerve palsy
Median nerve palsy Median nerve palsy
Median nerve palsy
Bijay Mehta
 

What's hot (20)

Recurrent Dislocation of patella -PAWAN
Recurrent Dislocation of patella -PAWANRecurrent Dislocation of patella -PAWAN
Recurrent Dislocation of patella -PAWAN
 
Common peroneal nerve lesions
Common peroneal nerve lesionsCommon peroneal nerve lesions
Common peroneal nerve lesions
 
Mallet finger
Mallet fingerMallet finger
Mallet finger
 
PRINCIPLES OF TENDON TRANSFERS
PRINCIPLES OF TENDON TRANSFERSPRINCIPLES OF TENDON TRANSFERS
PRINCIPLES OF TENDON TRANSFERS
 
Sprengel’s shoulder
Sprengel’s shoulderSprengel’s shoulder
Sprengel’s shoulder
 
radial nerve palsy
radial nerve palsy radial nerve palsy
radial nerve palsy
 
Radial club hand (Radial Dysplasia)
Radial club hand (Radial Dysplasia)Radial club hand (Radial Dysplasia)
Radial club hand (Radial Dysplasia)
 
Genu varum, Genu valgum, Genu recurvatum
Genu varum, Genu valgum, Genu recurvatumGenu varum, Genu valgum, Genu recurvatum
Genu varum, Genu valgum, Genu recurvatum
 
Mallet finger
Mallet fingerMallet finger
Mallet finger
 
De quervain's
De quervain'sDe quervain's
De quervain's
 
Morton Neuroma
Morton Neuroma Morton Neuroma
Morton Neuroma
 
Foot drop
Foot dropFoot drop
Foot drop
 
Radial nerve injury
Radial nerve injuryRadial nerve injury
Radial nerve injury
 
Shoulder Instability
Shoulder InstabilityShoulder Instability
Shoulder Instability
 
Tarsal tunnel syndrome
Tarsal tunnel syndromeTarsal tunnel syndrome
Tarsal tunnel syndrome
 
Lateral epicondylitis
Lateral epicondylitisLateral epicondylitis
Lateral epicondylitis
 
Median nerve injuries and mangement
Median nerve injuries and mangementMedian nerve injuries and mangement
Median nerve injuries and mangement
 
Tennis elbow
Tennis elbowTennis elbow
Tennis elbow
 
Reflex Sympathetic Dystrophy (CRPS 1)
Reflex Sympathetic Dystrophy (CRPS 1)Reflex Sympathetic Dystrophy (CRPS 1)
Reflex Sympathetic Dystrophy (CRPS 1)
 
Median nerve palsy
Median nerve palsy Median nerve palsy
Median nerve palsy
 

Similar to Trigger finger/ Stenosing tenosynovitis

Ulnar Tunnel Syndrome (Cubital Tunnel Syndrome).pptx
Ulnar Tunnel Syndrome (Cubital Tunnel Syndrome).pptxUlnar Tunnel Syndrome (Cubital Tunnel Syndrome).pptx
Ulnar Tunnel Syndrome (Cubital Tunnel Syndrome).pptx
Ahmad Merajul Hasan Inam
 
Hand splinting in common orthopedic & neurological condition 1
Hand splinting in common orthopedic & neurological condition 1Hand splinting in common orthopedic & neurological condition 1
Hand splinting in common orthopedic & neurological condition 1
POLY GHOSH
 
Carpal tunnel syndrome
Carpal tunnel syndromeCarpal tunnel syndrome
Carpal tunnel syndrome
PratikDhabalia
 
Tigger thumb
Tigger thumbTigger thumb
Tigger thumb
drJaishreeRai
 
Carpel tunnel syndrome
Carpel tunnel syndromeCarpel tunnel syndrome
Carpel tunnel syndrome
Shruti Shirke
 
Handand wristexam
Handand wristexamHandand wristexam
Handand wristexamIreland64
 
Misc. affections of soft tissue
Misc. affections of soft tissueMisc. affections of soft tissue
Misc. affections of soft tissue
Dr. Anshu Sharma
 
Trigger finger
Trigger fingerTrigger finger
Trigger finger
NehaJagtap14
 
Wrist and Hand Management.pptx
Wrist and Hand Management.pptxWrist and Hand Management.pptx
Wrist and Hand Management.pptx
Rutuja Butala
 
Tennis elbow
Tennis elbowTennis elbow
Tennis elbow
PratikDhabalia
 
Common hand injuries
Common hand injuriesCommon hand injuries
Common hand injuries
tbf413
 
TMJ diagnosis
TMJ diagnosisTMJ diagnosis
TMJ diagnosis
IAU Dent
 
Mextensor tendon&teno
Mextensor tendon&tenoMextensor tendon&teno
Mextensor tendon&teno
Phakjira Nut
 
BRACHIAL PLEXUS INJURY EDITED.pptx
BRACHIAL PLEXUS INJURY EDITED.pptxBRACHIAL PLEXUS INJURY EDITED.pptx
BRACHIAL PLEXUS INJURY EDITED.pptx
UzairieAnwar2
 
Wristand hand-2.pptx
Wristand hand-2.pptxWristand hand-2.pptx
Wristand hand-2.pptx
AhmedMufleh1
 
Elbow disorders 5th stage lecture (dr.farouk)
Elbow disorders 5th stage lecture (dr.farouk)Elbow disorders 5th stage lecture (dr.farouk)
Elbow disorders 5th stage lecture (dr.farouk)
FarouqAbdulkareem
 
physiotherapy management for rheumatoid arthritis.pdf
physiotherapy management for rheumatoid arthritis.pdfphysiotherapy management for rheumatoid arthritis.pdf
physiotherapy management for rheumatoid arthritis.pdf
AliMufleh1
 
Claw Hand,Definition,Causes,Types,Symptoms and Management
Claw Hand,Definition,Causes,Types,Symptoms and ManagementClaw Hand,Definition,Causes,Types,Symptoms and Management
Claw Hand,Definition,Causes,Types,Symptoms and Management
Dr.Md.Monsur Rahman
 
Clinical signs of upper limb
Clinical signs of upper limbClinical signs of upper limb
Clinical signs of upper limb
SamiullahAzeem
 
Tendinopathies of wrist and hand
Tendinopathies of wrist and handTendinopathies of wrist and hand
Tendinopathies of wrist and hand
dinesh sharma
 

Similar to Trigger finger/ Stenosing tenosynovitis (20)

Ulnar Tunnel Syndrome (Cubital Tunnel Syndrome).pptx
Ulnar Tunnel Syndrome (Cubital Tunnel Syndrome).pptxUlnar Tunnel Syndrome (Cubital Tunnel Syndrome).pptx
Ulnar Tunnel Syndrome (Cubital Tunnel Syndrome).pptx
 
Hand splinting in common orthopedic & neurological condition 1
Hand splinting in common orthopedic & neurological condition 1Hand splinting in common orthopedic & neurological condition 1
Hand splinting in common orthopedic & neurological condition 1
 
Carpal tunnel syndrome
Carpal tunnel syndromeCarpal tunnel syndrome
Carpal tunnel syndrome
 
Tigger thumb
Tigger thumbTigger thumb
Tigger thumb
 
Carpel tunnel syndrome
Carpel tunnel syndromeCarpel tunnel syndrome
Carpel tunnel syndrome
 
Handand wristexam
Handand wristexamHandand wristexam
Handand wristexam
 
Misc. affections of soft tissue
Misc. affections of soft tissueMisc. affections of soft tissue
Misc. affections of soft tissue
 
Trigger finger
Trigger fingerTrigger finger
Trigger finger
 
Wrist and Hand Management.pptx
Wrist and Hand Management.pptxWrist and Hand Management.pptx
Wrist and Hand Management.pptx
 
Tennis elbow
Tennis elbowTennis elbow
Tennis elbow
 
Common hand injuries
Common hand injuriesCommon hand injuries
Common hand injuries
 
TMJ diagnosis
TMJ diagnosisTMJ diagnosis
TMJ diagnosis
 
Mextensor tendon&teno
Mextensor tendon&tenoMextensor tendon&teno
Mextensor tendon&teno
 
BRACHIAL PLEXUS INJURY EDITED.pptx
BRACHIAL PLEXUS INJURY EDITED.pptxBRACHIAL PLEXUS INJURY EDITED.pptx
BRACHIAL PLEXUS INJURY EDITED.pptx
 
Wristand hand-2.pptx
Wristand hand-2.pptxWristand hand-2.pptx
Wristand hand-2.pptx
 
Elbow disorders 5th stage lecture (dr.farouk)
Elbow disorders 5th stage lecture (dr.farouk)Elbow disorders 5th stage lecture (dr.farouk)
Elbow disorders 5th stage lecture (dr.farouk)
 
physiotherapy management for rheumatoid arthritis.pdf
physiotherapy management for rheumatoid arthritis.pdfphysiotherapy management for rheumatoid arthritis.pdf
physiotherapy management for rheumatoid arthritis.pdf
 
Claw Hand,Definition,Causes,Types,Symptoms and Management
Claw Hand,Definition,Causes,Types,Symptoms and ManagementClaw Hand,Definition,Causes,Types,Symptoms and Management
Claw Hand,Definition,Causes,Types,Symptoms and Management
 
Clinical signs of upper limb
Clinical signs of upper limbClinical signs of upper limb
Clinical signs of upper limb
 
Tendinopathies of wrist and hand
Tendinopathies of wrist and handTendinopathies of wrist and hand
Tendinopathies of wrist and hand
 

Recently uploaded

Non-respiratory Functions of the Lungs.pdf
Non-respiratory Functions of the Lungs.pdfNon-respiratory Functions of the Lungs.pdf
Non-respiratory Functions of the Lungs.pdf
MedicoseAcademics
 
Surat @ℂall @Girls ꧁❤8527049040❤꧂@ℂall @Girls Service Vip Top Model Safe
Surat @ℂall @Girls ꧁❤8527049040❤꧂@ℂall @Girls Service Vip Top Model SafeSurat @ℂall @Girls ꧁❤8527049040❤꧂@ℂall @Girls Service Vip Top Model Safe
Surat @ℂall @Girls ꧁❤8527049040❤꧂@ℂall @Girls Service Vip Top Model Safe
Savita Shen $i11
 
Flu Vaccine Alert in Bangalore Karnataka
Flu Vaccine Alert in Bangalore KarnatakaFlu Vaccine Alert in Bangalore Karnataka
Flu Vaccine Alert in Bangalore Karnataka
addon Scans
 
POST OPERATIVE OLIGURIA and its management
POST OPERATIVE OLIGURIA and its managementPOST OPERATIVE OLIGURIA and its management
POST OPERATIVE OLIGURIA and its management
touseefaziz1
 
Maxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptx
Maxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptxMaxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptx
Maxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptx
Dr. Rabia Inam Gandapore
 
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...
Oleg Kshivets
 
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...
i3 Health
 
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdf
ARTIFICIAL INTELLIGENCE IN  HEALTHCARE.pdfARTIFICIAL INTELLIGENCE IN  HEALTHCARE.pdf
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdf
Anujkumaranit
 
Alcohol_Dr. Jeenal Mistry MD Pharmacology.pdf
Alcohol_Dr. Jeenal Mistry MD Pharmacology.pdfAlcohol_Dr. Jeenal Mistry MD Pharmacology.pdf
Alcohol_Dr. Jeenal Mistry MD Pharmacology.pdf
Dr Jeenal Mistry
 
BENIGN PROSTATIC HYPERPLASIA.BPH. BPHpdf
BENIGN PROSTATIC HYPERPLASIA.BPH. BPHpdfBENIGN PROSTATIC HYPERPLASIA.BPH. BPHpdf
BENIGN PROSTATIC HYPERPLASIA.BPH. BPHpdf
DR SETH JOTHAM
 
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists  Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists
Saeid Safari
 
Factory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in Stock
Factory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in StockFactory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in Stock
Factory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in Stock
rebeccabio
 
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdf
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfMANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdf
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdf
Jim Jacob Roy
 
basicmodesofventilation2022-220313203758.pdf
basicmodesofventilation2022-220313203758.pdfbasicmodesofventilation2022-220313203758.pdf
basicmodesofventilation2022-220313203758.pdf
aljamhori teaching hospital
 
Hemodialysis: Chapter 3, Dialysis Water Unit - Dr.Gawad
Hemodialysis: Chapter 3, Dialysis Water Unit - Dr.GawadHemodialysis: Chapter 3, Dialysis Water Unit - Dr.Gawad
Hemodialysis: Chapter 3, Dialysis Water Unit - Dr.Gawad
NephroTube - Dr.Gawad
 
For Better Surat #ℂall #Girl Service ❤85270-49040❤ Surat #ℂall #Girls
For Better Surat #ℂall #Girl Service ❤85270-49040❤ Surat #ℂall #GirlsFor Better Surat #ℂall #Girl Service ❤85270-49040❤ Surat #ℂall #Girls
For Better Surat #ℂall #Girl Service ❤85270-49040❤ Surat #ℂall #Girls
Savita Shen $i11
 
Physiology of Special Chemical Sensation of Taste
Physiology of Special Chemical Sensation of TastePhysiology of Special Chemical Sensation of Taste
Physiology of Special Chemical Sensation of Taste
MedicoseAcademics
 
Charaka Samhita Sutra sthana Chapter 15 Upakalpaniyaadhyaya
Charaka Samhita Sutra sthana Chapter 15 UpakalpaniyaadhyayaCharaka Samhita Sutra sthana Chapter 15 Upakalpaniyaadhyaya
Charaka Samhita Sutra sthana Chapter 15 Upakalpaniyaadhyaya
Dr KHALID B.M
 
THOA 2.ppt Human Organ Transplantation Act
THOA 2.ppt Human Organ Transplantation ActTHOA 2.ppt Human Organ Transplantation Act
THOA 2.ppt Human Organ Transplantation Act
DrSathishMS1
 
heat stroke and heat exhaustion in children
heat stroke and heat exhaustion in childrenheat stroke and heat exhaustion in children
heat stroke and heat exhaustion in children
SumeraAhmad5
 

Recently uploaded (20)

Non-respiratory Functions of the Lungs.pdf
Non-respiratory Functions of the Lungs.pdfNon-respiratory Functions of the Lungs.pdf
Non-respiratory Functions of the Lungs.pdf
 
Surat @ℂall @Girls ꧁❤8527049040❤꧂@ℂall @Girls Service Vip Top Model Safe
Surat @ℂall @Girls ꧁❤8527049040❤꧂@ℂall @Girls Service Vip Top Model SafeSurat @ℂall @Girls ꧁❤8527049040❤꧂@ℂall @Girls Service Vip Top Model Safe
Surat @ℂall @Girls ꧁❤8527049040❤꧂@ℂall @Girls Service Vip Top Model Safe
 
Flu Vaccine Alert in Bangalore Karnataka
Flu Vaccine Alert in Bangalore KarnatakaFlu Vaccine Alert in Bangalore Karnataka
Flu Vaccine Alert in Bangalore Karnataka
 
POST OPERATIVE OLIGURIA and its management
POST OPERATIVE OLIGURIA and its managementPOST OPERATIVE OLIGURIA and its management
POST OPERATIVE OLIGURIA and its management
 
Maxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptx
Maxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptxMaxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptx
Maxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptx
 
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...
 
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...
 
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdf
ARTIFICIAL INTELLIGENCE IN  HEALTHCARE.pdfARTIFICIAL INTELLIGENCE IN  HEALTHCARE.pdf
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdf
 
Alcohol_Dr. Jeenal Mistry MD Pharmacology.pdf
Alcohol_Dr. Jeenal Mistry MD Pharmacology.pdfAlcohol_Dr. Jeenal Mistry MD Pharmacology.pdf
Alcohol_Dr. Jeenal Mistry MD Pharmacology.pdf
 
BENIGN PROSTATIC HYPERPLASIA.BPH. BPHpdf
BENIGN PROSTATIC HYPERPLASIA.BPH. BPHpdfBENIGN PROSTATIC HYPERPLASIA.BPH. BPHpdf
BENIGN PROSTATIC HYPERPLASIA.BPH. BPHpdf
 
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists  Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists
 
Factory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in Stock
Factory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in StockFactory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in Stock
Factory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in Stock
 
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdf
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfMANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdf
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdf
 
basicmodesofventilation2022-220313203758.pdf
basicmodesofventilation2022-220313203758.pdfbasicmodesofventilation2022-220313203758.pdf
basicmodesofventilation2022-220313203758.pdf
 
Hemodialysis: Chapter 3, Dialysis Water Unit - Dr.Gawad
Hemodialysis: Chapter 3, Dialysis Water Unit - Dr.GawadHemodialysis: Chapter 3, Dialysis Water Unit - Dr.Gawad
Hemodialysis: Chapter 3, Dialysis Water Unit - Dr.Gawad
 
For Better Surat #ℂall #Girl Service ❤85270-49040❤ Surat #ℂall #Girls
For Better Surat #ℂall #Girl Service ❤85270-49040❤ Surat #ℂall #GirlsFor Better Surat #ℂall #Girl Service ❤85270-49040❤ Surat #ℂall #Girls
For Better Surat #ℂall #Girl Service ❤85270-49040❤ Surat #ℂall #Girls
 
Physiology of Special Chemical Sensation of Taste
Physiology of Special Chemical Sensation of TastePhysiology of Special Chemical Sensation of Taste
Physiology of Special Chemical Sensation of Taste
 
Charaka Samhita Sutra sthana Chapter 15 Upakalpaniyaadhyaya
Charaka Samhita Sutra sthana Chapter 15 UpakalpaniyaadhyayaCharaka Samhita Sutra sthana Chapter 15 Upakalpaniyaadhyaya
Charaka Samhita Sutra sthana Chapter 15 Upakalpaniyaadhyaya
 
THOA 2.ppt Human Organ Transplantation Act
THOA 2.ppt Human Organ Transplantation ActTHOA 2.ppt Human Organ Transplantation Act
THOA 2.ppt Human Organ Transplantation Act
 
heat stroke and heat exhaustion in children
heat stroke and heat exhaustion in childrenheat stroke and heat exhaustion in children
heat stroke and heat exhaustion in children
 

Trigger finger/ Stenosing tenosynovitis

  • 1. TRIGGER FINGER PRESENTED BY: DR. ZUNAIRA AHMAD
  • 2. DEFINITION • Inflammation and subsequent narrowing of pulley of affected digit (most commonlyA1) Typically 3rd, 4th digit • [Annular (A1-A5) ligaments of the tendon sheath over the flexor tendons] • Flexor tendon / tendon sheath thickens • The main characteristic of trigger finger is popping and / or catching with movement of the digit especially at bending.
  • 3. CLINICAL PRESENTATION • Initially, patients may present with painless clicking during movement of the digit. This can progress to painful catching or popping, typically at the MCP or PIP joints. • Possible additional symptoms are: • Stiffness and swelling (especially in the morning) • Intermittent finger locking during active flexion that requires a passive force to extend the finger • Finger locking or clicking in a bent position then popping straight • Loss of full flexion / extension • Palpable painful nodule proximal to A1, and / or finger locked into a flexed position
  • 4. DIFFERENTIAL DIAGNOSIS • Dupuytren's contracture • Flexor tendon / sheath tumor. • Sesamoid bone anomalies • Post-traumatic tendon entrapment on the metacarpal head
  • 5. • History • Past Medical History  Diabetic individuals are four times more likely to develop trigger finger  RA and Gout are also associated with trigger finger • Observation  A digit locked in flexion  Bony proliferative changes in the sub-adjacent PIP joint • Palpation • Range of Movement (Loss of motion, particularly in extension) • Manual Muscle Testing • Joint Accessory Mobility (PIP, MCP, DIP, and CMC of all affected digits) • Special Tests (Open and Close hand) EXAMINATION
  • 6. Physiotherapy 1. Rest 2. Splinting  6-10 weeks  2 types  At DIP joint (50% resolution of symptoms)  At MCP joint with 15 degrees of flexion. (92.9% resolution) 3. Exercises  AROM ( abduction, Adduction to strengthen interossei and the lumbricals)  Digital blocking  Tendon glide exercise  Duck  Hook  Squeeze  Touch and Trace  Spread wide MANAGEMENT 4 Hot/cold 5 Massage 6 Ultrasound 7 Electrical stimulation 8 Passive therapeutic traction 9 Extracorporeal Shockwave Therapy  Operative