Trigger digit/thumb

Trigger finger is a disorder characterised by intermittent triggering or locking of the finger or thumb with or without pain, generally occurring in the palm at the level of the metacarpophalangeal (MCP) joint. In most cases it is due to a non-inflammatory thickening of the digit’s A1 pulley with secondary entrapment and/or sometimes thickening of the tendon(s)/ inflammatory nodules; however the exact aetiology remains unclear.

• Mechanism of onset, nature of problem, location of pain, severity and longevity of symptoms, limitation to function.

1. Observe for visible triggering/disrupted movement pattern Trigger Finger (YouTube.com)
2. Palpate for thickening, tenderness and palpable triggering/disrupted movement pattern.

None required at this stage.

Dupuytren’s disease vs RA synovitis.

• Self-management and advice, patient information leaflets
• NHS Ayrshire & Arran. Trigger finger/thumb
• BSSH. Trigger finger/thumb.
• Use of a finger splint for night time

• Self massage nodule for up to 6 wks and monitor
• Corticosteroid injection if available.

Urgent referral to secondary care for a locked trigger finger which cannot be passively extended ( please consider/exclude Dupuytrens disease !)

Diagnostically uncertain
Symptoms persist beyond 6/52 and interfere with ADLs
Failed conservative management.