title: Bedside ultrasound identification of infectious flexor tenosynovitis in the emergency department.
abstract: Infectious flexor tenosynovitis (FTS) is a serious infection of the hand and wrist that can lead to necrosis and amputation without prompt diagnosis and surgical debridement. Despite the growing use of point-of-care ultrasound (POCUS) by emergency physicians there is only one reported case of the use of POCUS for the diagnosis of infectious FTS in the emergency department setting. We present a case of a 58 year-old man where POCUS identified tissue necrosis and fluid along the flexor tendon sheath of the hand. Subsequent surgical pathology confirmed the diagnosis of infectious FTS.
authors.affiliation: University of California, San Francisco, School of Medicine, San Francisco, California.
authors.forename: Kevin
authors.initials: K
authors.lastname: Padrez
authors.affiliation: Tufts University, School of Medicine, Boston, Massachusetts.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Bress
authors.affiliation: Alameda Health System, Emergency Department, Highland Hospital, Oakland, California.
authors.forename: Brian
authors.initials: B
authors.lastname: Johnson
authors.affiliation: University of California, San Francisco, School of Medicine, San Francisco, California ; Alameda Health System, Emergency Department, Highland Hospital, Oakland, California.
authors.forename: Arun
authors.initials: A
authors.lastname: Nagdev
mesh_terms: D004636:Emergency Service, Hospital; D006225:Hand; D006801:Humans; D008297:Male; D008875:Middle Aged; D000067716:Point-of-Care Testing; D013203:Staphylococcal Infections / Q000000981:diagnostic imaging*; D013717:Tenosynovitis / Q000000981:diagnostic imaging* / Q000382:microbiology*; D014463:Ultrasonography
references.citation: Rheumatology (Oxford). 2012 Jul;51(7):1246-60
references.pmid: 22378717
references.citation: Clin Exp Rheumatol. 2013 Jan-Feb;31(1):91-6
references.pmid: 23111117
references.citation: Ann Rheum Dis. 2013 Aug;72(8):1328-34
references.pmid: 22984169
references.citation: J Emerg Med. 2015 Jan;48(1):63-8
references.pmid: 25315997
references.citation: J Hand Surg Am. 1989 Mar;14(2 Pt 1):307-10
references.pmid: 2649550
references.citation: Infect Dis Clin North Am. 2005 Dec;19(4):991-1005, xi
references.pmid: 16297744
references.citation: J Bone Joint Surg Am. 2007 Aug;89(8):1742-8
references.pmid: 17671013
references.citation: Ann Emerg Med. 2009 Apr;53(4):550-70
references.pmid: 19303521
references.citation: BMC Musculoskelet Disord. 2011;12:91
references.pmid: 21549008
references.citation: J Am Acad Orthop Surg. 2012 Jun;20(6):373-82
references.pmid: 22661567