Finger infection: fluid in the sheath

Question 1Which finding supports flexor tenosynovitis?

1. aFluid surrounding the flexor tendon within a distended sheath
2. bA thin tendon with no fluid
3. cFluid only under the skin above a normal sheath
4. dA bright cortex with a shadow

Question 2Which Kanavel sign is pain on passive straightening of the finger?

1. aTenderness along the sheath
2. bFusiform swelling
3. cPain on passive extension
4. dA flexed resting position

Question 3A patient has all four Kanavel signs and the scan shows little fluid. What next?

1. aReassure: the scan is normal
2. bUrgent hand surgery review: the scan does not exclude infection
3. cDischarge with oral antibiotics
4. dRepeat the scan next week

Question 4Fluid above a normal sheath, under the skin, suggests what?

1. aA fracture
2. bA tendon rupture
3. cA superficial collection rather than tenosynovitis
4. dFlexor tenosynovitis

Question 5Why compare with a neighbouring finger?

1. aIt is never useful
2. bTo check the nail
3. cTo judge whether the fluid and sheath are abnormal
4. dTo measure blood pressure