Abstract
Background: Trigger finger (TF) is a painful disorder that hinders the use of the entire hand. Although the A1 pulley is a typical location for triggering, other areas may also be involved in some patients, according to many published studies. Objective: The objective of this study is to assess the validity of palpation in detecting the lesion site in diabetic TF patients, which is essential for proper topical physical therapy or surgical treatment. Methods: A case-control observational trial was conducted at the physical therapy outpatient clinic of Al-Ahrar Teaching Hospital in Zagazig, Egypt. Fifteen TF patients (cases) and 45 non-TF diabetic patients (controls) were examined by a physical therapist to identify the affected area (A1 pulley, other finger pulleys, mid-palm, or wrist). Confirmation was obtained through ultrasound examination by a radiologist. A 2x2 contingency table and receiver operating characteristic (ROC) curve were used to compute sensitivity, specificity, an accuracy. A 2x2 contingency table was used to compute positive predictive value and negative predictive value of palpation in detecting the lesion site in diabetic TF patients. Results: Palpation demonstrated a sensitivity of 91.67%, a specificity of 94.95%, and an accuracy rate of 94.76% in localizing TF pathology. The positive predictive value was 52.38%, and the negative predictive value was 99.47%. Conclusion: The results of this study demonstrate that palpation is a highly effective clinical tool for locating lesions in patients with diabetic TF. However, since the positive predictive value was only 52.38% and many cases were mildly affected, a larger study using MRI as a gold standard is needed, as it could detect early involvement.