Kanavel signs of flexor sheath infection: a cautionary tale

Hand infections are a common problem among the population and carry significant morbidity. Deep hand infection such as flexor sheath infections are surgical emergencies and require prompt referral to prevent permanent disability. A misdiagnosis of flexor sheath infection can potentially lead to severe stiffness, deformity, or amputation of the digit.

This article presents an unusual case of a 22-year-old with a chronic intermittent history of swelling and pain to the right middle finger (RMF). Although the history was slightly atypical, examination findings identified the Kanavel cardinal signs of tendon sheath infection (Figure 1).