Management of Pyogenic Flexor Tenosynovitis

» Pyogenic flexor tenosynovitis (PFT) is an uncommon closed-space infection of the hand that can result in severe stiffness and other sequela. » When PFT is recognized and treated with antibiotics before advanced disease, surgery is often unnecessary to achieve a cure. » Physical examination features are helpful in differentiating PFT from other finger infections, particularly when considered together in aggregate. » Laboratory values such as systemic inflammatory markers are usually normal in early cases of PFT and are more likely to be elevated in other diagnoses like cellulitis. » Imaging findings such as x-ray, ultrasound, and computed tomography scan remain investigational and are not routinely used to make the diagnosis. » Stiffness and contracture are the most common sequela and benefit from early motion and hand therapy.