What is a differential diagnosis of trigger finger?

Trigger thumb, also known as stenosing tenosynovitis, is a condition that affects the tendons in the thumb. It is characterized by the thumb getting stuck in a bent position and then suddenly popping or snapping straight. The name “trigger thumb” comes from the way the thumb moves, similar to pulling the trigger of a gun.

The primary cause of trigger thumb is the thickening or inflammation of the tendon sheath, which is the protective covering of the tendon. This thickening narrows the space through which the tendon moves, making it difficult for the thumb to straighten. The exact cause of trigger thumb is often unknown, but it can be associated with repetitive hand movements, gripping activities, or certain medical conditions like rheumatoid arthritis.

Symptoms of trigger thumb typically include:

1. The thumb becoming locked in a bent position.
2. A popping or snapping sensation when the thumb is straightened.
3. Pain or discomfort at the base of the thumb.
4. Tenderness or a lump at the base of the thumb.

Treatment options for trigger thumb may vary depending on the severity of the condition. Initially, conservative treatments are usually recommended, which may include:

1. Resting the thumb and avoiding activities that worsen the symptoms.
2. Applying ice to the affected area to reduce inflammation.
3. Taking over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve pain and inflammation.
4. Wearing a splint or brace to immobilize the thumb and allow it to rest.
5. Doing stretching and strengthening exercises under the guidance of a healthcare professional.

If conservative treatments do not provide relief, medical interventions may be considered. These can include:

1. Corticosteroid injections: Injecting a corticosteroid medication into the tendon sheath can help reduce inflammation and relieve symptoms.
2. Percutaneous release: A minimally invasive procedure where a needle is used to cut the thickened tendon sheath, allowing the tendon to move more freely.
3. Open surgery: In severe cases or when other treatments fail, a surgeon may perform a surgical procedure to release the tendon sheath and provide long-term relief.

It is important to consult with a healthcare professional, such as a doctor or an orthopedic specialist, for an accurate diagnosis and appropriate treatment options for trigger thumb. They can evaluate your specific condition and provide personalized recommendations.