{"id":951,"date":"2017-10-21T21:15:49","date_gmt":"2017-10-21T21:15:49","guid":{"rendered":"http:\/\/emultrasound.sdsc.edu\/?p=951"},"modified":"2020-07-22T00:05:20","modified_gmt":"2020-07-22T00:05:20","slug":"a-case-of-comparision","status":"publish","type":"post","link":"https:\/\/emultrasound.ucsd.edu\/index.php\/2017\/10\/21\/a-case-of-comparision\/","title":{"rendered":"Case # 8: A Case of Comparision"},"content":{"rendered":"
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A 40\u00a0year old male\u00a0presents to the emergency department with pain to the entire right thumb\u00a0and wrist for 1 day. \u00a0He notes that he suffered a small puncture wound to his right thumb 1 day ago while working on his car. \u00a0The patient has notable circumferential, non-erythematous swelling to his right thumb with tenderness along the flexor tendon. There is also fullness of the dorsum of his wrist. He is holding his fingers flexed and has pain radiating into the wrist with any movement of his fingers or wrist, especially with extension of his fingers.<\/p>\n

Vitals: T 98.7\u00a0HR 90\u00a0BP 132\/81\u00a0 RR 13 O2 98% on RA<\/p>\n

A bedside ultrasound is performed, what is the next best step in management?<\/p>\n<\/div>\n<\/div>\n<\/div>\n

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\"Normal

Normal Left Thumb in Long Axis<\/p><\/div>\n<\/div>\n

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\"Abnormal

Abnormal Right Thumb in Long Axis<\/p><\/div>\n<\/div>\n<\/div>\n

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Answer and Learning Points<\/h3>
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Answer<\/strong><\/p>\n

Empirical antibiotic therapy and orthopedic surgery consultation for infectious flexor tenosynovitis (FTS). \u00a0The patient meets 4 out of 4 Kanavel's signs and has ultrasound evidence of FTS suggested by a thickened tendon with surrounding anechoic fluid.<\/span><\/p>\n

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Short Axis View of Right 1st Digit demonstrating hypoechoic fluid surrounding tendon.<\/figcaption><\/figure>\n

Learning Points<\/strong><\/p>\n