Rheumatoid Hand: Flexor Tenosynovitis


Flexor tenosynovitis is an inflammation of the synovial lining of the flexor tendon sheaths of the wrist and digits. The disease occurs in 64% to 94% of patients with rheumatoid arthritis and can lead to pain, hand dysfunction, and tendon rupture. Clinical manifestations include crepitus, triggering, locking, and decreased active motion of the digits. Nonsurgical treatment consists of rest, splinting, and local corticosteroid injection. Surgical intervention is warranted after 4 to 6 months of unsuccessful medical treatment. This article discusses the use of digital tenosynovectomy to improve flexor tendon gliding, prevent tendon rupture, and improve function of the hand.

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