Bury the Buzzword: Kanavel Signs

This buzzword deals with the diagnosis of septic flexor tenosynovitis, which can occur in a finger when the flexor tendon becomes infected. The most common cause of this infection is from an injury. The term is an eponym, named after the surgeon Allen Kanavel.

There are four different Kanavel signs. If all are exhibited in a patient, then the diagnosis of septic flexor tenosynovitis can be made.

The four Kanavel signs are as follows:

·        Swelling of the entire finger

·        Pain with passive extension

·        Pain with palpation of the flexor surface

·        Finger held in slight flexion at rest

When this diagnosis is made, an orthopedic surgeon must be consulted immediately because it is considered an emergency. Left untreated, the patient may lose the finger.

I had never heard of these signs before until my ER rotation. These signs are important to remember not just in the ER setting, but also in the office setting where a patient may come to you after they have suffered an injury to their finger. It is imperative to recognize these signs because surgical intervention is needed along with antibiotics to minimize complications.

Sources:

Likes, Randle L. "Infectious and Inflammatory Flexor Tenosynovitis." Emedicine.medscape.com. Ed. Harris Gellman. WebMD, 8 Sept. 2009. Web. 16 Dec. 2011. <http://emedicine.medscape.com/article/1239040-overview>.

Phemister, Dallas B. "ALLEN B. KANAVEL 1874–1938." Annals Of Surgery 108.2 (1938): 161-62. NIH.gov. PubMed Central. Web. 16 Dec. 2011. <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1386889/>.

Sexton, DJ. Infectious tenosynovitis. In: UpToDate, Basow, DS (Ed), UpToDate, Waltham, MA, 2011.