M20.021

Clinical Causes: Trauma or injury to the finger, such as a forceful blow or jam Tendon rupture or tear in the central slip of the extensor tendon Rheumatoid arthritis, which weakens the tendons and joint structures Repeated stress or overuse of the finger Previous dislocation or fracture affecting the finger joint

Key Symptoms: Bent position of the finger at the middle joint (PIP), causing a characteristic deformity Swelling and tenderness around the affected joint Pain at the deformity site, especially when moving the finger Reduced ability to straighten or fully extend the finger The finger may appear bent or deformed, with difficulty performing fine motor tasks In cases linked to arthritis, symptoms may include joint stiffness and warmth

Diagnosis Path: Diagnosis typically involves a physical examination by a healthcare professional, who assesses the finger’s alignment, range of motion, and tenderness. Imaging tests such as X-rays can help identify any associated fractures or joint damage, and confirm the deformity's extent. In some cases, additional tests may be performed to rule out underlying conditions like rheumatoid arthritis.

Treatment Protocols: Management strategies for boutonnière deformity depend on the severity and underlying cause. Common options include: - **Splinting:** Applying a finger splint to hold the PIP joint in the correct position, usually for several weeks. - **Physical therapy:** Exercises to strengthen surrounding muscles and restore movement. - **Medications:** Anti-inflammatory drugs to reduce swelling and pain, if applicable. - **Surgical intervention:** In cases where deformity is severe or does not improve with conservative treatments, surgery may be performed to repair or reconstruct damaged tendons or joints. - **Lifestyle adjustments:** Activities that minimize stress on the finger, and ergonomic modifications, may help prevent worsening or recurrence.