Congenital stenosing tenosynovitis is also known as congenital trigger finger because it is common in the thumb and occasionally in other fingers. Clinical manifestations are limited extension of the distal interphalangeal joint of the thumb. Passive extension can be felt or heard popping, localized pain can be felt. Small nodules are often found on the palmar side of the first metacarpophalangeal joint. Pathologic changes are thickening of the tendon sheath at the first metacarpal bone, development of the tendon sheath duct, and obstruction of the passage of the flexor tendon. Treatment: Surgery: incision of the thickened and narrowed tendon sheath.