Hand Therapy Practice Exam Question 21 ANSWER


Correct Answer: C. Infectious tenosynovitis 

The patient is experiencing all four signs of Kanavel which indicate acute infectious/pyogenic flexor tenosynovitis.  Not all four signs need to be present for diagnosis. Infectious tenosynovitis can occur with penetrating trauma from an animal bite or foreign body (In this case a thorn from a rose bush).   The patient should be referred to her surgeon for urgent medical intervention.  Left untreated, infectious tenosynovitis can lead to tendon necrosis and rupture.   Stenosing tenosynovitis or trigger finger (Answer A.) is a non urgent medical condition that causes catching or locking of a digit with active flexion.  In this condition repetitive use or systemic illness such as diabetes causes swelling of the flexor tendon and prevents normal tendon glide under a flexor pulley (typically the A-1 pulley).  Herpetic Whitlow (Answer B.) is a finger tip infection caused by the Herpes virus.  This infection can be found more commonly in medical and dental professionals.   Gout (Answer D.) causes painful and inflamed joints due to the build up or uric acid crystals within the joint.   Pain tends to be localized and not diffuse.

Reference: Green’s Operative Hand Surgery Electronic Location 3295

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