Question

Which of the following is true about tenosynovitis of the finger?

• A. Fingers held in mild extension / extension deformity at the involved fingers
• B. Tenosynovitis of little finger will spread to thumb rather than ring finger
• C. With involvement of little finger the infection can spread to the index finger
• D. Treatment is conservative

Hint:

Radial and ulnar bursae communicate, so little finger infection reaches the thumb (horseshoe abscess).

Answer 1

The Correct Option is B

Step 1: Pyogenic flexor tenosynovitis is infection of the synovial sheath surrounding a flexor tendon.
Step 2: The flexor sheath of the thumb continues as the radial bursa, and the flexor sheath of the little finger continues as the ulnar bursa. These two bursae often communicate at the wrist via the space of Parona.
Step 3: Because of this connection, infection of the little finger sheath can track to the thumb (and vice versa), producing a "horseshoe" abscess. So option b is true.
Step 4: Option a is wrong - the digit is held in slight flexion (Kanavel sign), not extension. Spread to the index finger (c) is not the typical pathway, and treatment is usually surgical drainage with antibiotics, not conservative, so d is wrong.