Stenosing Tenosynovitis (Trigger Finger and Trigger Thumb)

Abstract

Trigger finger (or thumb) arises either from thickening of the flexor tendon sheath (which occurs following tenosynovitis of infective, traumatic or rheumatolgical origin) or from nodular thickening of the flexor tendon itself which may be congenital. In either case, smooth passage of the tendons through their sheaths is compromised, causing symptoms of delayed and sometimes painful extension of the digit (commonly the middle finger), perhaps accompanied by a cracking sound. Patients commonly report having to straighten the finger physically, which otherwise remains locked in the flexed position. It is associated with several systemic conditions including diabetes and rheumatoid arthritis, but is also related to repetitive strain injuries. When seen in industrialised countries whose populace spend many hours a week playing video games and using mobile phones to send text messages it has been dubbed ‘texting tendonitis’, to which we might add ‘Game-Boy thumb’! The prevalence of this condition may rise with increasing use of mobile phones and games' consoles. Below, we review web sites currently available as learning resources for clinicians and patients.