“…Triggering has been associated with mucopolysaccharidosis, juvenile rheumatoid arthritis, Ehlers-Danlos syndrome, Down syndrome, and central nervous system disorders such as delayed motor development. 10,11,14,15 In addition to generalized syndromes, multiple anatomic anomalies have been described including decussation of the flexor digitorum superficialis (FDS) proximal to the A1 pulley, aberrant lumbrical muscles such as insertion of the lumbrical into the FDS, and other abnormal relationships between the FDS and flexor digitorum profundus (FDP) tendons (Fig. 2).…”