Extensor hood syndrome--osteophytic irritation of digital extensor tendons in rock climbers

Injuries to the flexor tendons and flexor tendon pulleys are frequently reported in rock climbers. Osteoarthritic changes with bone spurs are also well known. We report on the less commonly described extensor tendon irritation caused by such osteophytes.

Thirteen high-level rock climbers (12 men, 1 woman; average age 33.8 years [range 17-55]; average years of climbing experience 19 [range 5-30]; average climbing level 10.2) with extensor hood irritation caused by dorsally located osteophytes of proximal interphalangeal (n = 10) or distal interphalangeal joints (n = 3) were evaluated and managed. Twelve climbers received conservative therapy and 1 climber was treated surgically.

Before treatment, the climbers were unable to achieve their normal climbing ability due to extensor tendon irritations with resultant effusion noted in the ultrasound examinations. After conservative treatment, and in 1 case surgery, all patients achieved their previous climbing ability.

While all climbers were able to achieve their former climbing level after treatment, the condition is progressive and the osteoarthritic changes will likely cause further problems for these individuals in the future. Extensor hood irritation must be considered in the differential diagnosis of finger pain in rock climbers.