Infectious tenosynovitis: Difference between revisions
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==Background== | ==Background== | ||
* Infection of extensor tendons rarely result in loculated infections, but disruption of normal flexor tendon function can be dangerous as it may spread proximally involving the wrist/forearm (Parona space). | |||
* Infection of extensor tendons rarely result in loculated infections | |||
==Etiology == | ==Etiology == | ||
Revision as of 06:26, 31 December 2013
Background
- Infection of extensor tendons rarely result in loculated infections, but disruption of normal flexor tendon function can be dangerous as it may spread proximally involving the wrist/forearm (Parona space).
Etiology
- Trauma with direct inoculation
- Microbiology
- "Clean trauma" - skin flora
- DM, bites - Polymicrobial (gram -, anerobes)
- Puncture from plants - Fungal (sporotrichosis)
- Hematogenous spread
- Microbiology
- Gonorrhea
- Look for vesiculopustular skin lesion, polyarthralgia
- Mycobacteria
- Contiguous spread
Clinical Manifestations
- Pain along the tendon with passive extension (early sign)
- Tenderness along the course of the flexor sheath (late sign)
- Symmetric enlargement of the affected digit
- Slightly flexed finger at rest
Diagnosis
- Xray
- Usually normal but helpful to r/o bony involvement, FB
- Blood culture
Treatment
- Surgery consult for wash-out versus debridement
- IV Abx (appropriate to the likely organism)