Post Traumatic Tenosynovitis in the index finger after wrestling

Patient

Q: I am not sure the exact problem with my finger. About 30 minutes after wrestling, I felt slight stiffness and slight pain in my index finger. I didn't think much of it, I just thought that I might have sprained it slightly. Then during the middle of the night, I felt deep pain and I slipped on a finger splint that I had from previous injury. I inspected the finger in the morning and it was swollen and I was unable to bend it from the 2nd joint for more than about 15 degrees. I am able to bend from the knuckle and the joint at the tip of the finger. It has been about a week now, the swelling is mostly gone but I cannot bend it any more than a week ago. It was never bruised or discolored. There is no pain at the bottom-side of my finger. However, there is a very slight pain close to the knuckle joint and the 2nd (middle) joint when pressed on the top-side of the finger. Also there is pain when I try to bend it. Can you tell me what might be wrong?

Doctor

A:   Most likely the symptoms that you are experiencing in your  index finger are caused by an inflammation of the tendon  , the tendon sheath and possibly the capsule surrounding the joint: called Tenosynovitis. Often, as in your case, there is a history of recent trauma or repetitive use (overuse) of the affected finger. The healing time may be different on each particular case, the improvement does not come overnight, sometimes takes longer, and so be patient. The conservative treatment include the following: avoid activities that reproduce the pain (activities modification), use of anti-inflammatory medication (i.e: “Aleve”, “Advil”), and protection and splinting of the affected finger. If there is poor or no improvement, then the local corticosteroid injection may be considered.

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