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Infectious tenosynovitis is the infection of closed synovial sheaths in the flexor tendons of the fingers. It is usually caused by trauma, but bacteria can spread from other sites of the body. Although tenosynovitis usually affects the flexor tendon of the fingers, the disease can also affect the extensor tendons occasionally. [5]
Medial injury of the flexor tendon is estimated to occur in 0.4% of the population. [1] It occurs most often in people ages 45 to 64, is more common in women than in men, and with 75% of cases in the dominant arm. [1] Risk factors for developing golfer's elbow include improper technique or lack of strength, endurance, or flexibility. [1]
Tendinopathy is a type of tendon disorder that results in pain, swelling, and impaired function. [2] The pain is typically worse with movement. [2] It most commonly occurs around the shoulder (rotator cuff tendinitis, biceps tendinitis), elbow (tennis elbow, golfer's elbow), wrist, hip, knee (jumper's knee, popliteus tendinopathy), or ankle (Achilles tendinitis).
Kanavel's sign is a clinical sign found in patients with infection of a flexor tendon sheath in the hand (pyogenic flexor tenosynovitis), a serious condition which can cause rapid loss of function of the affected finger. [1] The sign consists of four components: [2] the affected finger is held in slight flexion.
The patient needs to be in a seated position with the elbow flexed to 90°, forearm pronated (palm facing the ground), and the arm stabilized against the thorax. [2] [3] [4] The examiner places the stabilizing hand on the proximal portion of the humerus near the bicipital groove, and the resistance hand on the distal forearm and wrist. [1] [2]
Finkelstein's test was described by Harry Finkelstein (1865–1939), an American surgeon, in 1930. [5]A similar test was previously described by Eichhoff, in which the thumb is placed in the palm of the hand and held with the fingers, and the hand is then ulnar deviated (see images), causing intense pain over the radial styloid which disappears if the thumb is released.
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The rupture occurred in a proximal biceps tendon, resulting in retraction distally. This is one of the two forms of the "Popeye deformity." This image shows a biceps brachii tendon rupture on the left arm. The rupture occurred in the distal biceps tendon, resulting in retraction of the muscle belly proximally.