Multimodal Medical Rehabilitation with Ultrasound Guidance in Trigger Finger: A Case Report

Abstract

Trigger finger (stenosing flexor tenosynovitis) is a commonly encountered musculoskeletal disorder of the hand, characterized by pain, stiffness, and a “clicking” or locking phenomenon caused by thickening of the A1 pulley that impedes flexor tendon movement. This condition predominantly affects elderly women and is often associated with repetitive activities that result in chronic microtrauma of the tendon–pulley system. Musculoskeletal ultrasonography plays an important role in establishing the diagnosis and guiding non-surgical interventions such as USG-guided corticosteroid injection. A 67-year-old woman presented with complaints of pain and stiffness in the middle finger of the right hand for the past six months. The diagnosis of trigger finger digiti III manus dextra grade III (Green’s classification) was established based on clinical findings of tenderness, clicking, and locking phenomenon, as well as ultrasonographic findings demonstrating A1 pulley thickening and tenosynovitis. Management was performed using a multimodal medical rehabilitation approach, including Shortwave Diathermy (SWD), therapeutic ultrasound, and intrathecal corticosteroid injection (triamcinolone) under ultrasound guidance. After four weeks of therapy, the patient demonstrated pain reduction (VAS from 6 to 1), resolution of locking, and full recovery of hand functional activity. Ultrasound-based medical rehabilitation approach proved to be effective, safe, and efficient in reducing pain, improving tendon function, and accelerating recovery in non-surgical trigger finger cases. The combination of physical modalities and ultrasound-guided injection represents a primary therapeutic option capable of reducing recurrence rates and improving patients’ quality of life.