Images in Clinical Medicine
An Unusual Cause of Trigger Finger
N Engl J Med 2011; 365:e14August 18, 2011
- Article
Video
An Unusual Cause of Trigger Finger.
A 62-year-old left-handed man presented with a long-standing history of intermittent snapping and painful locking of the fourth finger of the left hand. This occurred particularly with writing. He had no history of hand trauma or inflammatory arthropathy. The physical examination revealed that flexion of the fourth finger at the metacarpophalangeal joint resulted in ulnar subluxation of the extensor digitorum tendon (Panel A, arrow). This movement produced a trigger-finger effect, with occasional locking that required assisted reduction (Panel B, arrow, and video). Subluxation of the extensor digitorum tendon is an uncommon cause of trigger finger. It results from disruption or laxity of the radial sagittal bands that stabilize the tendon over the metacarpal head. It is usually associated with trauma (a so-called boxer's knuckle) or inflammatory joint diseases, such as rheumatoid arthritis. If the condition is the result of recent trauma, prompt splinting may be of some help. Otherwise, surgical repair may be pursued if functional impairment or symptoms are sufficiently severe. In this case, the patient declined surgical intervention in favor of conservative management. There was no change at 1-year follow-up.
Shawn A. Chillag, M.D.
Stephen Greenberg, M.D.
University of South Carolina, Columbia, SC
shawn.chillag@uscmed. sc. edu - Citing Articles (1)
Citing Articles
1
Montse Erra, Imma Moreno, Jordi Sanahuja, Miriam Andrés, Raquel F. Reinoso, Estrella Lozoya, Pilar Pizcueta, Núria Godessart, Julio Cesar Castro-Palomino. (2011) Biaryl analogues of teriflunomide as potent DHODH inhibitors. Bioorganic & Medicinal Chemistry Letters 21:24, 7268-7272
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