What is tenosynovitis?

Updated: Aug 27, 2018
  • Author: Mark R Foster, MD, PhD, FACS; Chief Editor: Harris Gellman, MD  more...
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Tenosynovitis is inflammation of a tendon and its sheath. Most acute cases of flexor tenosynovitis (FT), which involves disruption of normal flexor tendon function in the hand, are the result of infection. However, FT also can develop secondary to acute or chronic inflammation from a noninfectious cause, such as diabetes, overuse, or arthritis. (See Pathophysiology and Etiology.)

Much of the original work on infectious FT was done by Kanavel. Septic FT is diagnosed if a patient presents with the four Kanavel signs, as follows (see Presentation and Workup):

  • Finger held in slight flexion
  • Fusiform swelling
  • Tenderness along the flexor tendon sheath
  • Pain with passive extension of the digit

Septic FT has the ability to rapidly destroy a finger's functional capacity and is considered an orthopedic emergency. (See Prognosis, Treatment, and Medication.)

For patient education information, see the Infections Center, as well as Tendinitis and Rheumatoid Arthritis.

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