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Updated: Jul 29, 2025

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[Trigger finger-pitfalls and differential diagnosis].

A Cavalcanti Kußmaul1, A Ayache2, F Unglaub2,3

  • 1Klinik für Orthopädie und Unfallchirurgie, Muskuloskelettales Universitätszentrum München (MUM), Klinikum der Universität München, LMU München, Marchioninistr. 15, 81377, München, Deutschland. adrian.kussmaul@med.uni-muenchen.de.

Orthopadie (Heidelberg, Germany)
|May 26, 2023
PubMed
Summary
This summary is machine-generated.

A prominent articular tuberosity caused persistent trigger finger symptoms in a patient, even after A1-annular ligament release. Surgical excision of the tuberosity successfully restored normal finger mobility.

Keywords:
ExostosisLigaments, articularMetacarpophalangeal jointSnapping fingerStenosing tendovaginitis

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Area of Science:

  • Orthopedic Surgery
  • Radiology
  • Hand Surgery

Background:

  • Trigger finger, or stenosing tenosynovitis, presents diagnostic challenges, particularly when symptoms persist post-operatively.
  • The A1-annular ligament is a common site for release surgery in trigger finger treatment.
  • Recalcitrant trigger finger cases necessitate exploring alternative etiologies beyond simple ligament adhesions.

Observation:

  • A 32-year-old male experienced persistent snapping of the right index finger at the metacarpophalangeal joint.
  • Symptoms persisted despite a prior surgical release of the A1-annular ligament and lacked localized tenderness.
  • Computed Tomography (CT) revealed a prominent articular tuberosity as a potential cause.

Findings:

  • Computed Tomography (CT) imaging identified an unusually prominent articular tuberosity.
  • Magnetic Resonance Imaging (MRI) did not reveal any other pathological abnormalities.
  • Surgical revision involved the excision of the prominent articular tuberosity.

Implications:

  • Prominent articular tuberosities can mimic or contribute to trigger finger symptoms, complicating diagnosis.
  • This case highlights the importance of advanced imaging like CT in identifying bony abnormalities in trigger finger.
  • Surgical excision of the articular tuberosity offers a viable solution for refractory trigger finger cases caused by this specific anomaly.