Flexor tenosynovitis

PURPOSE: Resection of the radial or ulnar slip of the flexor digitorum superficialis (FDS) tendon is a known treatment option for persistent trigger finger. Risk factors for undergoing FDS slip excision are unclear. We hypothesized that patients who underwent A1 pulley release with FDS slip excision secondary to persistent triggering would have a higher comorbidity burden compared to those receiving A1 pulley release alone. METHODS: We identified all adult patients who underwent A1 pulley release with FDS slip excision because of persistent triggering either intraoperatively or postoperatively from 2018 to 2023...

INTRODUCTION: Purulent flexor tenosynovitis (PFT) is a severe condition, and many patients report serious postoperative complications such as amputation, limited range of motion (ROM), or recurrence of symptoms. However, the ideal protocol for PFT treatment remains unknown owing to the limited number of studies. This retrospective cohort study aimed to identify prognostic factors for PFT treatment outcomes. MATERIALS AND METHODS: Sixty-six patients (46 men and 20 women) with PFT who underwent surgical debridement at our hospital between September 2005 and January 2023 were included in this study...

This study aimed to investigate the dimensions and types of the os trigonum and evaluate their relationship with various pathologic conditions on the posterior ankle using ankle MRI images. A total of 124 non-contrast-enhanced ankle and foot MR images of 123 consecutive patients were included in this retrospective study. The images were presented randomly, and they contained no patient information. The MR images were retrospectively and independently reviewed by two reviewers with a fellowship-trained musculoskeletal radiologist...

BACKGROUND: Inflammation around the tendons of interosseous muscles of the hand (interosseous tendon inflammation) was recently observed with MRI for the first time in patients with rheumatoid arthritis and in at-risk individuals with detectable anti-citrullinated protein antibodies, generating the hypothesis that interosseous tendon inflammation precedes clinical arthritis. To better understand the role of interosseous tendon inflammation during the development of rheumatoid arthritis, we studied the frequency of interosseous tendon inflammation in healthy individuals and in those with arthralgia that was suspected of progressing to rheumatoid arthritis (ie, clinically suspect arthralgia) and the association of interosseous tendon inflammation with other symptoms of inflamed joint tissues and with clinical arthritis development...

Among extrapulmonary tuberculosis, osteoarticular tuberculosis is a rare manifestation, and cases related to osteoarticular tuberculosis of large joints have been reported previously. However, tuberculous tenosynovitis causing carpal tunnel syndrome is a rare manifestation, especially in the background of rheumatoid arthritis. A 67-year-old Sri Lankan male with a background of rheumatoid arthritis presented with progressively enlarging left wrist swelling associated with pain and numbness for 2 months...

Snapping of fingers can be caused by pathologies such as stenosing flexor tenosynovitis. However, snapping symptoms in the metacarpophalangeal (MP) joint caused by hypertension and hyperplasia of the lateral band are rare. We present a 26-year-old female with symptoms of painful snapping of the middle finger. When the finger was actively flexed from the hyperextension of the MP joint, the ulnar lateral band was prominent, and a snapping phenomenon occurred. The cause of the snapping finger was considered to be tightness of the ulnar lateral band, and surgery was planned...

BACKGROUND: Sarcoidosis is a multisystem disease characterized by granuloma formation in various organs. Sarcoidosis-related flexor tendon contractures are uncommon in clinical settings. This contracture is similar to stenosing tenosynovitis and potentially leads to misdiagnosis and mistreatment. Herein, we report a rare case of sarcoidosis-related finger flexor tendon contracture that was misdiagnosed as tenosynovitis. CASE SUMMARY: A 44-year-old woman presented to our department with flexion contracture of the right ring and middle fingers...

BACKGROUND: Trigger finger (TF; a type of stenosing tenosynovitis) is common, affecting the flexor tendons of the hand, often causing significant pain and functional impairment. Treatment can include splinting, corticosteroid injection, or surgical release. There is little published research on the role of electroacupuncture (EA) for treating TF. CASE: After more than 1 year of pain and triggering, a 58 year-old male had locking of his left, fourth ring finger requiring painful manual reduction...

INTRODUCTION: Flexor tenosynovitis (FTS) is a deep space infection of an upper extremity digit which carries a high rate of morbidity. OBJECTIVE: This review highlights the pearls and pitfalls of FTS, including presentation, diagnosis, and management in the emergency department (ED) based on current evidence. DISCUSSION: FTS typically occurs after direct penetrating trauma to the volar aspect of an upper extremity digit. Development of a deep space infection that quickly propagates through the flexor tendon sheath of a digit can result in serious structural damage to the hand and place the patient at risk for significant morbidity such as finger amputation or even result in death...

Tenosynovitis of the digital flexor tendon sheath (DFTS) is diagnosed using ultrasonography and contrast tenography. Nevertheless, making a precise preoperative diagnosis is challenging. This study aimed to determine and compare the sensitivity and specificity of low-field MRI and MRI tenography (MRIt) to detect artificially created soft-tissue lesions in the DFTS. In 21 DFTSs, 118 lesions were made tenoscopically in the superficial digital flexor tendon (SDFT), deep digital flexor tendon (DDFT), manica flexoria (MF) and proximal scutum...

KEY CLINICAL MESSAGE: Tenosynovitis with rice bodies is a rare presentation, diagnosable by MRI. Surgical excision is the preferred treatment for tendon sheath masses containing rice bodies. The etiology was Mycobacterium tuberculosis in our case, highlighting the need to consider extrapulmonary TB in atypical presentations, ensuring effective treatment. ABSTRACT: Rice body tenosynovitis is a rare clinical phenomenon with various etiologies. Inflammatory diseases such as rheumatoid arthritis and tuberculosis have been shown to be associated with this condition...

AIMS: Diabetic cheiroarthropathies limit hand mobility due to fibrosis and could be markers of a global profibrotic trajectory. Heterogeneity in definitions and lack of a method to measure it complicate studying associations with organ involvement and treatment outcomes. We measured metacarpophalangeal (MCP) joint extension as a metric and describe magnetic resonance (MR) imaging determinants of MCP restriction. METHODS: Adults with type 1 diabetes were screened for hand manifestations using a symptom questionnaire, clinical examination, and function [Duruoz hand index (DHI) and grip strength]...

The trapezium tunnel is situated on the lateral side of the carpal tunnel, lined with synovial tissue, and accommodates the flexor carpi radialis tendon. Trapezium tunnel syndrome is characterized by flexor carpi radialis tendinitis/peritendinitis and may lead to complicated clinical scenarios, such as flexor carpi radialis tendon rupture and the formation of primary or recurrent ganglion cysts on the volar radial side of the wrist and thenar area. Notably, the simultaneous presence of trapezium tunnel syndrome might contribute to unsuccessful outcomes in carpal tunnel surgeries...

BACKGROUND: Gout is a common type of inflammatory arthritis caused by the deposition of monosodium urate crystals in the joints and surrounding tissues. It typically appears with abrupt and intense pain, redness, and swelling in the affected joint. It frequently targets the lower extremities, such as the big toe. However, rarely, gout can manifest in atypical locations, including the hands, leading to an uncommon presentation known as gouty tenosynovitis. However, it can result in significant morbidity owing to the potential for severe complications, such as myonecrosis and compartment syndrome...

Infected aortic aneurysms are rare, and have a high mortality rate. Although not a major pathogen, Streptococcus pyogenes has been reported to cause infected aortic aneurysms. In the present case, the patient was hospitalized for pyogenic flexor tenosynovitis with S. pyogenes bacteremia. Despite drainage of the abscess around the flexor tendon and effective antimicrobial therapy, infected aneurysms developed in the abdomen and ascending aorta. Because of their rapid enlargement, these aneurysms were treated with in situ reconstruction...

OBJECTIVE: To compare the ultrasonography (US) assessment of the retinacula of ankles in patients with rheumatoid arthritis (RA) and psoriatic arthritis (PsA). METHODS: This cross-sectional study included RA or PsA patients with ankle pain and healthy controls. The following US features were recorded: presence of synovitis, tenosynovitis and abnormalities of two retinacula (the superior peroneal retinaculum [SPR] and the flexor retinaculum [FR] evaluated in mode B and power Doppler)...

INTRODUCTION AND IMPORTANCE: Although 'congenital' or paediatric trigger thumb is commonly seen in the paediatric age group, adult presentation is very rare. However it is crucial to acknowledge the occurrence of unusual manifestations of paediatric trigger thumbs, since paediatric trigger thumbs are considered a separate disease entity compared to the commonly seen stenosing tenosynovitis in adults. CASE PRESENTATION: We report a case of a 18-year-old young lady presenting with atraumatic locked trigger thumb, which was successfully treated surgically with intra-operative finding confirming abnormally thickened flexor pollicis longus tendon signifying a paediatric trigger thumb pathology...

BACKGROUND: Non-septic tenosynovitis is a clinically relevant and often performance limiting musculoskeletal injury in the horse. OBJECTIVES: To review the published literature to determine which tendon sheaths are commonly affected by non-septic tenosynovitis and to describe the most frequently reported pathological lesions, outcomes, and surgical complications in equine non-septic tenosynovitis. STUDY DESIGN: Systematic review. METHODS: Literature searches were conducted in July 2021 from the online search engines PubMed, Scopus, Web of Science Core, VetMed Resource and ProQuest Theses & Dissertations...

Prolotherapy is used to treat chronic musculoskeletal diseases. The efficacy of prolotherapy was recently acknowledged. However, it has not been usually used to treat trigger fingers. Our study was a case report of aggravated flexor tenosynovitis and a fibrous nodule on thickened A1 pulley after repetitive prolotherapy for treating the trigger finger. A 47-year-old electrical engineer complained of a locked and painful triggering in his right ring finger. Preoperative ultrasonography revealed a large hyperechoic mass on the A1 pulley and tenosynovitis...

Giant cell tumor of the tendon sheath (GCTTS) is a common mass in the digits, hands, and upper extremities. Diagnosis is made on clinical examination, adjunctive imaging, and distinct intraoperative findings. Surgical excision is the mainstay of treatment. GCTTS are typically found on flexor surfaces with the dorsal distal thumb being an unusual location. Any surgical approach to the digit should balance oncologic margins with preserving function. GCTTS have a tendency to recur and should be approached in a methodical manner with risk factors of recurrence in mind...