Diferencia entre revisiones de «Flexor tenosynovitis»
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#*Flexed posture of involved digit at rest to minimize pain | #*Flexed posture of involved digit at rest to minimize pain | ||
== | ==Differential Diagnosis== | ||
{{Template:Hand Infection DDX}} | {{Template:Hand Infection DDX}} | ||
== | ==Workup== | ||
''W/U should be an adjunct to a clinical diagnosis'' | |||
*CBC | |||
*ESR | |||
*[[Ultrasound (Main)|Ultrasound]] | |||
*Xray | |||
==Management== | |||
#Antibiotics | #Antibiotics | ||
##Start immediately | ##Start immediately | ||
##[[Vancomycin]] 1gm IV q12hr + ([[Ampicillin/Sulbactam]] 1.5gm IV q6h OR [[cefoxitin]] 2gm IV q8h OR [[Piperacillin/Tazobactam]] 3.375gm IV q6h) | ##[[Vancomycin]] 1gm IV q12hr + ([[Ampicillin/Sulbactam]] 1.5gm IV q6h OR [[cefoxitin]] 2gm IV q8h OR [[Piperacillin/Tazobactam]] 3.375gm IV q6h) | ||
#Consult hand surgery in the ED | #Consult hand surgery in the ED | ||
==Disposition== | |||
*Typically require I&D in the OR | |||
==See Also== | ==See Also== | ||
*[[Hand Infection]] | *[[Hand Infection]] | ||
== | ==External Links== | ||
==Sources== | |||
*Tintinalli | *Tintinalli | ||
<references/> | |||
[[Category:ID]] | [[Category:ID]] | ||
[[Category:Ortho]] | [[Category:Ortho]] | ||
Revisión del 23:38 9 mar 2015
Background
- Surgical emergency; flexor sheaths are contiguous w/ deep spaces of the hand
- Usually associated with penetrating trauma
Clinical Features
- Kanavel's Signs:
- Percussion tenderness
- Tenderness over entire length of flexor tendon sheath
- Uniform swelling
- Symmetric finger swelling along length of the tendon sheath
- Pain w/ passive extension
- Often the first sign seen
- Flexion posture
- Flexed posture of involved digit at rest to minimize pain
Differential Diagnosis
Hand and finger infections
- Bed bugs
- Closed fist infection (Fight Bite)
- Hand cellulitis
- Hand deep space infection
- Hand-foot-and-mouth disease
- Herpetic whitlow
- Felon
- Flexor tenosynovitis
- Paronychia
- Scabies
- Sporotrichosis
Look-Alikes
Workup
W/U should be an adjunct to a clinical diagnosis
- CBC
- ESR
- Ultrasound
- Xray
Management
- Antibiotics
- Start immediately
- Vancomycin 1gm IV q12hr + (Ampicillin/Sulbactam 1.5gm IV q6h OR cefoxitin 2gm IV q8h OR Piperacillin/Tazobactam 3.375gm IV q6h)
- Consult hand surgery in the ED
Disposition
- Typically require I&D in the OR
See Also
External Links
Sources
- Tintinalli