From the Guidelines
Trigger finger and tenosynovitis of the flexor tendon sheath are distinct clinical entities with different presentations, where trigger finger is characterized by catching, locking, or popping sensations, and tenosynovitis presents with diffuse pain, swelling, and tenderness along the tendon. The clinical presentation of trigger finger typically includes catching, locking, or popping sensations during finger movement, particularly when attempting to extend a flexed finger, as well as a palpable nodule at the base of the affected finger and morning stiffness 1. In contrast, tenosynovitis of the flexor tendon sheath presents with more diffuse pain, swelling, and tenderness along the course of the tendon, often with visible swelling and erythema, and pain with both active and passive movement. Some key differences between the two conditions include:
- Trigger finger represents a more advanced stage where the tendon nodule and narrowed sheath create mechanical interference with smooth tendon gliding
- Tenosynovitis represents the inflammatory process that often precedes trigger finger development
- Trigger finger is typically characterized by a more localized presentation, while tenosynovitis presents with more diffuse symptoms The diagnosis of these conditions can be made through a combination of clinical examination and imaging studies, such as ultrasonography or magnetic resonance imaging, which can help to confirm the presence of tendon or synovial pathology 1. Treatment for both conditions should prioritize conservative management, including rest, NSAIDs, splinting, and corticosteroid injections, with surgical intervention reserved for persistent cases. It's worth noting that the provided evidence does not directly compare the clinical presentation of trigger finger and tenosynovitis, but rather provides information on the diagnosis and treatment of various musculoskeletal conditions, including tendon and synovial pathology 1.
From the Research
Clinical Presentation of Trigger Finger and Tenosynovitis Flexor
The clinical presentation of trigger finger and tenosynovitis flexor can be similar, but there are some key differences:
- Trigger finger, also known as stenosing flexor tenosynovitis, is a common pathology of the fingers causing functional deficit of the hand 2.
- Tenosynovitis flexor, on the other hand, refers to the inflammation of the tendon sheath, which can cause pain, swelling, and stiffness in the affected finger 3.
- The main difference between the two conditions is that trigger finger is characterized by a sudden release or locking of a finger during flexion or extension, whereas tenosynovitis flexor may not necessarily cause triggering or locking 4.
Symptoms and Signs
The symptoms and signs of trigger finger and tenosynovitis flexor can overlap, but some key differences include:
- Trigger finger typically presents with a palpable click or snap as the finger is flexed or extended, whereas tenosynovitis flexor may present with pain, swelling, and stiffness in the affected finger 5.
- Tenosynovitis flexor may also cause crepitus or grating sensation in the affected finger, which is not typically seen in trigger finger 3.
Diagnosis and Treatment
The diagnosis and treatment of trigger finger and tenosynovitis flexor can be similar, but some key differences include:
- Trigger finger can be treated with conservative management, such as activity modification, splinting, and corticosteroid injections, whereas tenosynovitis flexor may require more aggressive treatment, such as surgical release of the tendon sheath 5.
- Physical therapies, such as external shock wave therapy and ultrasound therapy, can be effective in treating trigger finger, but may not be as effective in treating tenosynovitis flexor 4.