HSS Ultrasound of the Month Case 139

Clinical History 76 year old male with chronic painful swollen index finger

Ultrasound of the Month – Case 139

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Ultrasound of the Month – Case 139

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Ultrasound of the Month – Case 139

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Diagnosis: Inflammatory Flexor Tenosynovitis Tenosynovitis is inflammation of the tendon sheath, and the differential diagnosis includes posttraumatic, inflammatory, and infectious etiologies.

Fluid in the tendon sheath, often with surrounding soft tissue edema, is the hallmark of tenosynovitis on imaging.

MRI and ultrasound are both excellent imaging modalities for diagnosing tenosynovitis.

Ultrasound has the additional advantage of being able to detect hyperemia on Doppler, which increases specificity for active inflammation.

In the current case, the patient subsequently gave a history of injury to the finger while gardening, and the ultimate diagnosis was septic tenosynovitis by MAI (Mycobacterium avium-intracellulare).

Ultrasound of the Month – Case 139

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