Trigger finger / thumb

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Patient Information

GP Information

Background Information

  • Inflammation of the flexor sheath or tendon resulting in entrapment at the A1 pulley.
  • Associated with diabetes, rheumatoid arthritis and amyloidosis.
  • Patients typically complain of finger clicking, pain at the base of the finger and catching or locking of the finger.
  • Examination may reveal a palpable nodule in the palm overlying the MPCJ with a catching sensation as the nodule enters the pulley, or a finger locked in flexion.

Investigation Guidelines

  • Investigations are not required for treatment or prior to referral.

Management Recommendations

  • Initial management is conservative.
  • Explanation and advice.
  • Up to 3 steroid injections 1 month apart may be given into the flexor sheath at the A1 pulley if skilled (50% success in diabetics and not recommended in the thumb due to risk of damage to digital nerves).
  • Referral indications: Diagnostic uncertainty, referral for steroid injection, failure to respond to steroid injection, surgery required.