is the inhibition of smooth tendon gliding due to mechanical impingement at the level of the A1 pulley that causes progressive pain, clicking, catching, and locking of the digit.
10% of diabetic population
more common in females older than 50
Associated conditions
rheumatoid arthritis
calcific tendinitis
carpal tunnel syndrome – >60% of patients with trigger digits have clinical or electrodiagnostic evidence of carpal tunnel syndrome
diabetes
amyloidosis
hypothyroidism
sarcoidosis
gout/pseudogout
Symptoms
pain at the level of the A1 pulley
clicking
catching
finger becoming “locked” in flexed position at the proximal interphalangeal (PIP) joint
may have referred pain to dorsal MCP/PIP region
Physical exam
tenderness at level of A1 pulley
palpable nodule of the flexor tendon
flexion and extension of the digit may reproduce symptoms
Treatment
splinting, activity modification, NSAIDs
corticosteroid injection – relief in 60% to 90% of cases
diabetics may be less likely to obtain relief of symptoms
