Which clinical history is characteristic of trigger finger (TF)?

Updated: Apr 26, 2021
  • Author: Satishchandra Kale, MD, MBBS, MBA, MCh(Orth), FRCS(Edin), FRCS(Tr&Orth); Chief Editor: Harris Gellman, MD  more...
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Answer

Patients with trigger finger (TF) may have a history of diabetes mellitus (DM) or rheumatoid arthritis (RA). In these individuals, multiple digits may be involved in TF.

Some patients will have a history of repetitive trauma to the affected area, while others may have occupational duties requiring repetitive use of the involved tendons. [31]

Signs and symptoms of TF are as follows:

  • Locking or catching during active flexion-extension activity (passive manipulation may be needed to extend the digit in the later stages)
  • Stiff digit, especially in long-standing or neglected cases
  • Pain over the distal palm
  • Pain radiating along the digit
  • Triggering on active or passive extension by the patient
  • Palpable snapping sensation or crepitus over the A1 pulley
  • Tenderness over the A1 pulley
  • Palpable nodule in the line of the flexor digitorum superficialis (FDS), just distal to the metacarpophalangeal (MCP) joint in the palm
  • Fixed-flexion deformity in late presentations, especially in the proximal interphalangeal (PIP) joint
  • Evidence of associated conditions (eg, RA, gout)
  • Early signs of triggering in other digits (may be bilateral)

A classic complaint is difficulty in achieving full extension of a single digit, which eventually releases or snaps open with pain at the distal palm and into the digit.

Some patients have difficulty with finger flexion rather than extension, though the former is less common. Other patients may have a painful nodule in the distal palm without any catching or triggering.

Some patients report stiffness in the fingers, especially after they have been asleep or following other periods of inactivity.

Some patients report swelling of the affected digit, particularly at the digit's base or proximal aspect.


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