Fortney Thomas A, Mead Kelly C, Wright Travis E, Sin Jessica M, Warhold Lance G
Department of Orthopaedics, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH, 03756-0001, USA.
Geisel School of Medicine, Dartmouth College, 1 Rope Ferry Road, Hanover, NH, 03755-1404, USA.
J Ultrasound. 2022 Jun;25(2):365-368. doi: 10.1007/s40477-021-00567-x. Epub 2021 Feb 6.
Pyogenic flexor tenosynovitis (PFT) is an aggressive infection of the flexor tendon sheath, requiring prompt intervention to minimize adverse outcomes. The diagnosis of pediatric PFT is often delayed due to the variable presence of Kanavel's signs in children and communication difficulties. A 9-month-old male presented to the emergency department with one of four Kanavel signs. The diagnosis of PFT was delayed until ultrasound was used to identify a fluid collection within the flexor tendon sheath. He was successfully treated with surgical debridement and antibiotic therapy, achieving full recovery by 6-month follow-up. This represents the youngest reported case of PFT. Difficulties with communication and physical exam as well as the variability of Kanavel's signs in young children can delay the diagnosis of pediatric PFT. Ultrasound can be a useful adjunct when clinical history and exam are equivocal, especially in children who present prior to language acquisition.
化脓性屈指肌腱腱鞘炎（PFT）是屈指肌腱鞘的一种侵袭性感染，需要及时干预以将不良后果降至最低。由于儿童中卡纳韦尔征的表现不一以及沟通困难，小儿PFT的诊断常常延迟。一名9个月大的男性因出现卡纳韦尔征中的一项而就诊于急诊科。PFT的诊断一直延迟到使用超声检查发现屈指肌腱鞘内有液体积聚。他通过手术清创和抗生素治疗获得成功治愈，在6个月的随访时完全康复。这是报道的最年幼的PFT病例。沟通和体格检查方面的困难以及幼儿卡纳韦尔征的变异性会延迟小儿PFT的诊断。当临床病史和检查不明确时，超声检查可能是一种有用的辅助手段，尤其是对于在语言习得之前就诊的儿童。
