Diferencia entre revisiones de «Flexor tenosynovitis»
(Text replacement - "Category:Ortho" to "Category:Orthopedics") |
(Text replacement - " w/ " to " with ") |
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| Línea 1: | Línea 1: | ||
==Background== | ==Background== | ||
*Surgical emergency - flexor sheaths are contiguous | *Surgical emergency - flexor sheaths are contiguous with deep spaces of the hand | ||
*Usually associated with a penetrating trauma | *Usually associated with a penetrating trauma | ||
==Clinical Features== | ==Clinical Features== | ||
===Kanavel's Signs=== | ===Kanavel's Signs=== | ||
#Pain | #Pain with passive extension | ||
#*Often the first sign seen | #*Often the first sign seen | ||
#Percussion tenderness | #Percussion tenderness | ||
Revisión del 15:47 11 jul 2016
Background
- Surgical emergency - flexor sheaths are contiguous with deep spaces of the hand
- Usually associated with a penetrating trauma
Clinical Features
- Pain with passive extension
- Often the first sign seen
- Percussion tenderness
- Tenderness over entire length of flexor tendon sheath
- Uniform swelling
- Symmetric finger swelling along length of the tendon sheath
- 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
Diagnosis
Workup
- CBC
- ESR
- Ultrasound
- Xray
Evaluation
- Generally a clinical evaluation, based on history and physical exam
Management
- Emergent ortho (hand) consult in ED
- Antibiotics (start immediately if suspected)
- Vancomycin 1gm IV q12hr PLUS
- Ampicillin/Sulbactam 1.5gm IV q6h OR cefoxitin 2gm IV q8h OR Piperacillin/Tazobactam 3.375gm IV q6h
Disposition
- Admit
See Also
External Links
Video
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