Overview
Suppurative tenosynovitis involves inflammation and infection within the synovial sheath surrounding tendons, often affecting flexor tendons in the hand and wrist. It can arise from penetrating injuries or hematogenous spread, presenting as severe pain, swelling, and limited mobility 14.Diagnosis
Clinical Presentation: Severe pain, swelling, and restricted movement in the affected tendon sheath 1.
Imaging: Ultrasound or MRI may show fluid accumulation and thickening of the tenosynovium 1.
Laboratory Tests: Elevated white blood cell count and inflammatory markers 1.
Culture and Sensitivity: Essential for identifying the causative organism and guiding antibiotic therapy 14.Management
Antibiotics: Initial broad-spectrum coverage followed by targeted therapy based on culture results 14.
Surgical Intervention: Often required for definitive treatment, including incision and drainage 1.
Supportive Care: Immobilization with splinting, elevation, and pain management 1.Special Populations
Pediatrics: Less commonly reported but still occurs; diagnosis and management similar to adults 1.
Occupational Risk: Repetitive motions in professions like ophthalmology (e.g., intravitreal injections) can predispose to tenosynovitis, necessitating ergonomic interventions 3.Key Recommendations
Early Surgical Intervention for definitive treatment of suppurative tenosynovitis 1 (Evidence: Strong).
Culturing the Infected Site is crucial for guiding appropriate antibiotic therapy 14 (Evidence: Strong).
Implement Ergonomic Measures in high-risk professions to reduce repetitive strain injuries 3 (Evidence: Moderate).References
1 Garry C, Ernst A, Langford M, Adams DJ. Pyogenic flexor tenosynovitis due to . BMJ case reports 2023. link
2 Nimunkar AJ, Chun KS, Phung N, Wreksoatmodjo K, Yen TY, Radwin RG. Reducing thumb extensor risk in laboratory rat gavage. Applied ergonomics 2017. link
3 Belliveau MJ, Leung C, Abouammoh MA. Intravitreal injections inducing de quervain tenosynovitis: injector's wrist. Retinal cases & brief reports 2015. link
4 Gatt R, Cushieri P, Sciberras C. An unusual case of flexor sheath tenosynovitis. Journal of hand surgery (Edinburgh, Scotland) 1998. link80032-6)