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Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
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Myocarditis: Comprehensive Medical ManagementMyocarditis, the heart muscle inflammation, requires a comprehensive medical management strategy that addresses the underlying cause, provides supportive care, manages symptoms, and reduces cardiac workload.Infections and Autoimmune CausesAdminister appropriate antimicrobial therapy when an infectious agent causes myocarditis. For instance, penicillin treats infections caused by Group A Streptococcus. In cases where autoimmune processes are...
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Pericarditis III: Medical Management01:17

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The primary objectives of managing pericarditis are to determine the underlying cause, provide effective therapy for treatment and symptom relief, and promptly detect signs and symptoms of cardiac tamponade. The following outlines the essential aspects of medical management for pericarditis:ObjectivesDetermine the Cause: Identifying the underlying cause of pericarditis is crucial for targeted treatment. Causes include viral infections, autoimmune diseases, post-cardiac injury syndrome, and...
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Endocarditis III: Medical Management01:18

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Rheumatic Heart Disease III: Medical Management01:21

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Rheumatic heart disease (RHD) management can be divided into two main strategies: prevention and long-term management.Primary PreventionPrimary prevention focuses on timely diagnosis and management of group A streptococcal pharyngitis to prevent acute rheumatic fever. The most widely used antibiotic for treating this condition is intramuscular benzathine penicillin G.Acute Rheumatic Fever TreatmentThe primary treatment goal for a patient diagnosed with acute rheumatic fever is to suppress the...
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Related Experiment Video

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Polytetrafluoroethylene PTFE as a Suture Material in Tendon Surgery
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Management of Pyogenic Flexor Tenosynovitis.

George M Anderson1, Joshua D Proal1, Christopher S Crowe2

  • 1Department of Orthopaedic Surgery & Sports Medicine, University of Washington, Seattle, Washington.

JBJS Reviews
|April 17, 2026
PubMed
Summary
This summary is machine-generated.

Pyogenic flexor tenosynovitis (PFT) is a hand infection. Early recognition and antibiotic treatment can often prevent surgery, with physical exam aiding diagnosis over imaging.

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Area of Science:

  • Hand surgery
  • Infectious disease
  • Orthopedics

Background:

  • Pyogenic flexor tenosynovitis (PFT) is a rare but serious infection affecting the closed spaces of the hand.
  • Delayed diagnosis and treatment can lead to significant morbidity, including stiffness and contracture.

Purpose of the Study:

  • To review the key diagnostic features of PFT.
  • To emphasize the importance of early recognition and non-operative management.
  • To differentiate PFT from other common finger infections.

Main Methods:

  • Review of clinical presentation and diagnostic modalities for PFT.
  • Analysis of physical examination findings in differentiating PFT.
  • Evaluation of laboratory and imaging findings in PFT diagnosis.

Main Results:

  • Early PFT often presents with normal systemic inflammatory markers, unlike cellulitis.
  • Physical examination findings, when considered collectively, are crucial for diagnosis.
  • Imaging studies (X-ray, ultrasound, CT) are not routinely used for initial PFT diagnosis.
  • Antibiotic therapy alone can be curative in early, non-advanced PFT cases, avoiding surgery.

Conclusions:

  • Early recognition of PFT is key to successful non-operative management with antibiotics.
  • Clinical examination is paramount in diagnosing PFT, especially when compared to other finger infections.
  • Hand therapy and early motion are essential for managing sequelae like stiffness and contracture.