🎧 MSRA Podcast: Trigger Finger – When Tendons Get Stuck
🖐️ MSK Deep Dive | High-Yield for the MSRA
Ever felt your finger lock, catch, or click when you move it? 🎯 In this episode, we break down Trigger Finger (stenosing tenosynovitis) — a small mechanical problem with big day-to-day consequences. Ideal for MSRA prep or practical knowledge in clinic.
🧠 What Is Trigger Finger?
Inflammation causes thickening of the tendon or sheath, leading to a mismatch in size at the A1 pulley.
🎢 This causes a snapping or locking sensation when the finger moves — it might get stuck and then suddenly pop free.
📌 Causes & Risk Factors
• Repetitive hand movements (e.g. gripping tools)
• Rheumatoid arthritis
• Diabetes mellitus
• Age >40
• Female sex
• History of hand trauma
• Anatomical variations
⚙️ Pathophysiology
Think of the tendon as a rope, sliding through a tunnel.
🪤 A nodule (speed bump) on the tendon catches at the pulley entrance → snap, click, or lock.
🩺 Symptoms
• Pain/tenderness at base of the finger or thumb
• Stiffness, worse in the morning
• Audible/palpable clicking
• Finger may lock in flexion
• Often affects thumb, middle, or ring finger
• May feel a palpable nodule over the A1 pulley
🔍 Differential Diagnosis
🧐 Don’t confuse it with:
• Osteoarthritis
• Dupuytren’s contracture
• Flexor tendinitis
• Ganglion cyst near tendon
• Nerve compression
📊 Epidemiology
✅ Affects ~2–3% of the UK population
✅ More common in women >40
✅ Associated with systemic inflammatory diseases (RA, diabetes)
🧪 Diagnosis
• Clinical diagnosis based on history + exam
• No imaging usually required
• Ultrasound/MRI only if diagnosis uncertain
💉 Management Options
1️⃣ Conservative First-Line
• Rest
• Ice
• Splinting (especially at night)
• NSAIDs
• Hand therapy
2️⃣ Corticosteroid Injection
• Injected into the flexor sheath at the A1 pulley
• Often very effective – relief within days to weeks
• Can be repeated if needed
3️⃣ Surgical Release
• Minor procedure under local anaesthetic
• Cuts the tight pulley to allow smooth tendon glide
• Reserved for refractory or severe cases
🧠 Prognosis
👍 Good with early treatment
🔁 Recurrence possible if underlying causes persist
⚠️ Untreated = risk of permanent stiffness and functional impairment
📚 MSRA Revision Resources
📄 Revision Notes:
https://www.passthemsra.com/topic/trigger-finger-revision-notes/
🧠 Flashcards:
https://www.passthemsra.com/topic/trigger-finger-flashcards/
📖 Q&A Accordion Notes:
https://www.passthemsra.com/topic/trigger-finger-accordion-qa-notes/
🧪 Rapid Quiz:
https://www.passthemsra.com/topic/trigger-finger-rapid-quiz/
🎯 MSRA Quiz Bank:
https://www.passthemsra.com/quizzes/trigger-finger/
📘 Full MSK Course:
https://www.passthemsra.com/courses/msk-for-the-msra/
🎙️ A great example of a mechanical problem with a straightforward clinical solution — and a high-yield topic for your MSRA revision.
#MSRA #TriggerFinger #MSRARevision #PassTheMSRA #MSK #MSRAFlashcards #MSRAQandANotes #MSRAQuiz #MSRAQuestionBank #Tenosynovitis #ClickingFinger #StenosingTenosynovitis #MSRAExam #NICEGuidelines
