Flexor digitorum tenosynovitis - foreign body induced
Penetrating injury to left 3rd digit metacapo-phalangeal joint region on palmer aspect - 4 months back. Now complaining of local pain, swelling. Reduced finger movements.
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- Normal echopattern
- No tear
- Synovial thickening with effusion from mid / distal palm to distal interphalangeal joint
- Hypervascularity is noted.
- A linear echogenic structure ( 3.5 mm ) is seen in tendon sheath overlying mid / distal shaft
of proximal phalanx.
Extensor tendons - intact
Metacarpo-phalangeal joint - no effusion
Interphalangeal joints - no effusion.
Findings favour foreign body induced flexure digitorum tenosynovitis.
Flexure tenosynovitis is bumpy or lobulated due to presence of pulley system.
Surgical exploration done. A foreign body was seen more proximally than seen on USG.
- Ultrasound of the musculoskeletal system C. Martinoli S. Bianchi 1st Indian reprint 2k7 pages 520 -521