Gouty Stenosing Tenosynovitis: Trigger Finger as a First Presentation of Tophaceous Gout

Abstract

Summary: Gout can lead to the deposition of tophi and chronic arthritis, for which surgical management is indicated when tophi interfere with the function of the finger. This case report discusses the management of a 37-year-old man with a past medical history of gout who presented with triggering of his small finger from gouty infiltration of his flexor digitorum profundus (FDP) tendon. An exploratory procedure that included tenolysis and release of the A1 pulley was performed. Gouty infiltration of the FDP tendon was noted intraoperatively and biopsied, which was later confirmed by histopathological analysis as being gouty tophus. The patient regained full function of the affected finger postoperatively and has since had no recurrence. Gouty tenosynovitis is a rare cause of trigger finger and should be considered as part of the differential diagnosis. Treatment for gouty tenosynovitis consists of A1 pulley release and careful excision of gouty tophus to restore tendon glide and hand function.

Association between hyperlipidemia and trigger finger: A nationwide population-based cohort study

“…The LHID used ICD-9-CM codes to assess illness conditions. The following comorbidities were considered in the present study according to previous studies [6,9,[13][14][15][16][17][18][19]: diabetes mellitus (ICD-9-CM code 250), rheumatoid arthritis (ICD-9-CM code 714.0), hypertension (ICD-9-CM code 401), hypothyroidism (ICD-9-CM code 244.0), hyperthyroidism (ICD-9-CM code 242.9), gout (ICD-9-CM code 274.9), osteoarthritis (ICD-9-CM code 715.9), depression (ICD-9-CM code 296.2), carpal tunnel syndrome (ICD-9-CM code 354.0), distal radial fracture (ICD-9-CM code 813.42), cardiovascular disease (ICD-9-CM code 429.2) and obesity (ICD-9-CM codes 278.00-278.03, V77.8). To reduce data selection bias, these concomitant illnesses were identified and characterized based on a minimum of three outpatient visits or one hospitalization before trigger finger diagnosis.…”

Current Concepts in the Management of Advanced Trigger Finger

“…The most commonly affected digits are the ring finger and the thumb 8 . Other comorbidities that may predispose patients to the development of trigger finger include inflammatory diseases such as rheumatoid arthritis, gout, and pseudogout, and deposition diseases such as amyloidosis and sarcoidosis 9 . A genetic component may also exist; a genome-wide association study reported significant associations between 2 human genes that are implicated in the development of fibrocartilaginous metaplasia and an increased risk of trigger finger 10 .…”