Steemit Learning Challenge-S22W3; Trigger Finger"

Trigger finger(My learning)

Trigger finger is defined as condition affecting tendons and tendon sheaths in thumbs and fingers which is also called stenosing tenosynovitis.

Types

• Stenosing tenosynovitis is characterized by swelling and narrowing of tendon sheath.
• Non stenosing tenosynovitis is characterized by swelling of tendon sheath but in this case narrowing don't occurs.

Stages

• In pre triggering stage patient feels pain stiffness and tenderness in affected finger or thumb of mild level.
• In early triggering stage patient feels pain tenderness as well as clicking and snapping sound when patient bend or straight his finger and established triggering is also another name of this stage.
• In locking stage patient finger feels to lock while bending and requires force for straightening finger again and definitely pain and tenderness also present here.

Causes

• Repeated grasping, gripping, bending (flexing) cause tendon irritation.
• Injury to tendon or finger(Traumatic cause)
• Underlying medical cause(Diabetes, arthritis (rheumatoid), gout)
• Anatomical abnormalities in tendon or it's sheath.

Symptoms

• Clicking and snapping sound when bending and straightening of finger.
• Pain and tenderness at effected thumb or finger and worsen at bending or gripping.
• Presence of stiffness at affected area.
• Locking of finger while bending.
• Difficulty in straighten finger.

Treatment

• Rest and ice for pain and swelling.
• Stretching and strengthening exercises.
• Anti inflammatory and pain killers.
• Percutaneous release and open surgery as surgical treatment.

Prognosis

• Trigger finger of mild stage prognosis is 2 week.
• Trigger finger of moderate stage prognosis is 3 week.
• Trigger finger of moderate stage prognosis is 1-1.5 month .

Trigger finger (Diagnosis)

Clinical evaluation

• In clinical evaluation by taking medical history we will know about any history of injury or trauma of that affected side and occupational status of patient to know cause of problem.
• Ask for symptoms that what patient is feeling about pain type that is it burning stabbing,dull etc and also about pain continuity.

Examination and assessment

• In examination look for redness and swelling at effective finger or thumb.
• Palpate for checking either tenderness is present or not.
• Ask patient to bend and straighten the finger and hear for sound of clicking or snapping.

Perform the following special or assessment tests;

• Trigger finger test will be performed when doctor will applied little pressure to tendon trying for reproducing clicking or snapping sound and sensations.
• Finkelstein test will be performed by patient when he will make fist with affected finger and bend wrist towards his little finger at doctor instructions. If patient feel more pain and clicking sensation then test is positive.
• In Graston test Graston tool will be used for applying little pressure at tendon for checking tenderness there.

Imaging tests

• Ultrasound can be most commonly used for assessing tendon and tendon sheath morphology.
• MRI can be used to assess any soft tissue injury (Tendon and ligaments)
• X-ray can diagnose any bony abnormality or underlying condition like RA.

Diagnostic criteria	Distribution
Clinical evaluation	20%
Physical examination	20%
Assessment tests	40%
Imaging studies	20%

Performing exercises

https://youtube.com/shorts/PAPhGgMc28c?si=L0AjsH-ls-Qqv53L

Tendon glide

https://youtube.com/shorts/vAU_o429tSo?si=dRzPNsfjxEoevC6r

Finger joint massage

https://youtube.com/shorts/Sr01Oq0SKOk?si=JzfVsd5gncvdzOJW

Trigger finger stretch