Diferencia entre revisiones de «Flexor tenosynovitis»
(Text replacement - "==Diagnosis==" to "==Evaluation==") |
Sin resumen de edición |
||
| Línea 5: | Línea 5: | ||
==Clinical Features== | ==Clinical Features== | ||
===Kanavel's Signs=== | ===Kanavel's Signs=== | ||
*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== | ==Differential Diagnosis== | ||
| Línea 25: | Línea 21: | ||
===Evaluation=== | ===Evaluation=== | ||
*Generally a clinical | *Generally a clinical diagnosis, based on history and physical exam | ||
==Management== | ==Management== | ||
*Emergent | *Emergent hand surgery consult in ED | ||
*[[Antibiotics]] (start immediately if suspected) | *[[Antibiotics]] (start immediately if suspected) | ||
**[[Vancomycin]] 1gm IV q12hr ''' | **[[Vancomycin]] 1gm IV q12hr '''AND''' | ||
**[[Ampicillin/Sulbactam]] 1.5gm IV q6h '''OR''' [[cefoxitin]] 2gm IV q8h '''OR''' [[Piperacillin/Tazobactam]] 3.375gm IV q6h | **[[Ampicillin/Sulbactam]] 1.5gm IV q6h '''OR''' [[cefoxitin]] 2gm IV q8h '''OR''' [[Piperacillin/Tazobactam]] 3.375gm IV q6h | ||
| Línea 46: | Línea 42: | ||
==References== | ==References== | ||
<References/> | <References/> | ||
[[Category:ID]] | [[Category:ID]] | ||
[[Category:Orthopedics]] | [[Category:Orthopedics]] | ||
Revisión del 06:31 7 jul 2017
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
Evaluation
Workup
- CBC
- ESR
- Ultrasound
- Xray
Evaluation
- Generally a clinical diagnosis, based on history and physical exam
Management
- Emergent hand surgery consult in ED
- Antibiotics (start immediately if suspected)
- Vancomycin 1gm IV q12hr AND
- 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
{{#widget:YouTube|id=4oCzzvTiwew}}