Madhan Pandian MD., FIPM., CIPS., RMSK’s Post

View profile for Madhan Pandian MD., FIPM., CIPS., RMSK, graphic

MUSCULOSKELETAL SONOLOGIST & INTERVENTIONAL PAIN SPECIALIST

A seemingly simple intervention for Trigger Finger treatment. Pathogenesis of the trigger disease points to a fibro cartilagenous metaplasia of the tendon causing a nodule superficial to the flexor tendon. in patients who overuse the flexors, pain develops ( trigger later ) as the nodule traverses across a tight A1 pulley. Anatomically, these are 2 different structures with a normal A1 pulley getting involved only during flexion of the finger, when a distal nodule passes underneath a tight A1 pulley. Two very important points to ponder. 1. Be it by Surgical or interventional methods, which one is the treatment target? I target the nodule. 2. While performing a percutaneous steroid injection, which axis do you prefer? I prefer the long axis to target the nodule for fenestration prior to the injection. #chronicpain #triggerfinger #musculoskeletal #painmanagement #painmedicine #paineducation

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