SEARCH · PubMed Health

Results for “TENOSYNOVITIS”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 739 records · Page 41Linked to original sources

PubMed2003

Power Doppler analysis of tendon vascularization.

Forty-nine patients with tendonitis (patellar in 16, quadriceps in two, Achilles in 12, rotator cuff disease in 19) and 47 patients with tenosynovitis (acute tenosynovitis in 25, stenosing tenosynovitis in 22) underwent ultrasound (US) and Power Doppler (PD)-US examination. Spectral analysis of flow signals was performed in all patients. Ten patients (six with tendonitis, four with tenosynovitis) were rewired after medical therapy. Six healthy volunteers were also examined for control purposes. Three different patterns of flow distribution were found in patients with tendonitis and active tenosynovitis. The vessels of tendons without tendon sheaths began with great peduncles at the level of the peritendinous soft tissues and were then distributed inside the tendon (pattern I). A clear peritendinous hypervascular pattern was found in all active tenosynovitis, but no vessels were found inside the tendons (pattern II). In some cases of intratendinous or partial lesions PD-US revealed some vessels located near or inside the lesion (pattern II). On spectral analysis these vessels corresponded to arteries with a low resistance index or small venules. PD-US revealed a significant reduction of flow signals in patients rewired after medical therapy. No pathological flow signals were found either in patients with stenosing tenosynovitis or in the control group. PD-US gives us an in vivo confirmation of tendon vascularity. Spectral analysis adds further information to gray-scale US.

Adolescent↗

PubMed2002

[Technique and diagnostic value of musculoskeletal ultrasonography in rheumatology. Part 6: ultrasonography of the wrist/hand].

Sonography of the hands is especially helpful in the diagnosis of early arthritis. Sonography allows for a very sensitive detection of small joint-effusion, tenosynovitis and small erosive bone lesions earlier than conventional radiography. Musculoskeletal sonography is also helpful in morphological analysis of changes of the median nerve in patients with carpal tunnel syndrome. The following standard scans are suggested for the sonographic evaluation of the wrist: 1. dorsal longitudinal scan along the radio-carpal joint, 2) along the ulno-carpal joint, and 3) dorsal transverse scan along the wrist to detect joint fluid collection, synovitis, tenosynovitis, ganglia, irregularities of the bone surface in osteoarthritis, and erosions due to inflammatory disease, 4) volar longitudinal scan along the radio-carpal joint, and 5) along the ulno-carpal joint, and 6) volar transverse scan along the wrist to diagnose the same objective as the above mentioned scans and to evaluate the median nerve in cases of carpal tunnel syndrome. Optional scans are the following: 7) ulnar longitudinal 8) transverse scan along the ulnar joint space and the extensor carpi ulnaris muscle to detect tenosynovitis and caput ulnae syndrome, 9) radial longitudinal, and 10). transverse scan along the joint space to diagnose synovitis and tenosynovitis. The following standard scans are suggested for the sonographic evaluation of the fingers: 1) volar longitudinal, 2) volar transverse scan in extension along the finger joints to detect effusion and synovial proliferation, tenosynovitis, irregularities of the bone surface (osteophytes, erosions), 3) dorsal longitudinal scans in extension and flexion >70 degrees along the CMC I, MCP, PIP and DIP joints to evaluate effusion and synovial proliferation, tenosynovitis or tendinitis, irregularities of the bone surface (osteophytes, erosions), and 4) dorsal transverse scans along the finger joints to evaluate these structures in an additional dimension. Optional 5) scans include the following: medial longitudinal scan along the MCP I, II, PIP and DIP joints, and 6) lateral longitudinal scan along the MCP V, PIP and DIP joints to evaluate the erosive bone process and joint instability. A linear transducer with a frequency of between 7.5 and 12 MHz is recommendable. The anterior distance between the bone and the joint-capsule of the wrist is > or = 3 mm in probable and > or = 4 mm in definite synovitis or effusions. Synovitis or effusions are probable if the difference between right and left wrist is > or = 1 mm, and they are definite if the difference is > or = 2 mm. A carpal tunnel syndrome is probable with a cross-sectional area of the median nerve of > or = 12 mm(2).

Arthritis, Rheumatoid↗

PubMed1999

[Lesional pattern and clinical symptoms in rheumatoid flexor tendon disease].

OBJECTIVES: To assess complaints and clinical findings of rheumatoid hand flexor tendon disease in relationship to the anatomical site and the type of lesion in order to improve the diagnosis and enable early operative treatment with preservation of hand function. METHODS: 123 patients of the hands of 78 patients (66 female, 12 male) with a mean age of 57 years were analyzed retrospectively. Preoperative complaints and clinical findings were recorded according to their frequency. Three different types of flexor tendon disease were distinguished intraoperatively: isolated tenosynovitis, tenosynovitis with tendon lesion, and complete tendon rupture. RESULTS: 188 tendons showed isolated synovitis, 208 had a tendon lesion with synovitis, and 30 tendons a rupture. Tenosynovitis was found in the palm and wrist mainly. The 2nd, 3rd and 4th finger were most frequently involved. 81 tendon adhesions, 12 nodules, 63 superficial lesions and 52 defects were detected. These lesions were found mainly in the palm and the second and third ray. The profundus tendon was affected most often. Ruptures were detected most often in the wrist caused by bony spurs and tenosynovitis. A clinical difference between tenosynovitis with and without tendon lesion was not found. However, complaints and findings were different in the digit, palm, wrist and forearm. Ruptures had characteristic clinical findings. CONCLUSIONS: Rheumatoid flexor tendon disease is common. Tenosynovitis is often accompanied by tendon lesions. Ruptures occur as disease progresses. Exact assessment of complaints and clinical findings is mandatory to diagnose and localize flexor tendon disease. Early operative intervention helps to preserve the function of the hand.

Adult↗

PubMed2003

Magnetic resonance imaging in the assessment of synovial inflammation of the hindfoot in patients with rheumatoid arthritis and other polyarthritis.

OBJECTIVES: To describe the localisation of synovitis and tenosynovitis of the hindfoot observed on magnetic resonance imaging (MRI) in patients with chronic polyarthritis, and to correlate the findings of physical examination and MRI. METHODS: Patients with chronic polyarthritis, and one or two painful hindfoot were included. On physical examination and on MRI, the tibio-talar, talo-calcaneal, and talo-navicular and calcaneo-cuboidal joints were adjudged to have or not synovitis, and the tibialis anterior and posterior, the peroneus longus and brevis, the flector digitorum and hallucis longus tendons to have or not tenosynovitis. Criteria for synovitis and tenosynovitis were a high signal intensity on T2-weighted images, a low signal intensity on T1-weighted images, and enhancement after Gd-DTPA injection, in the joint area, and around the tendon, respectively. The correlation between the findings of physical examination and those of MRI were evaluated using the Kappa statistics. RESULTS: 12 patients (three men, nine women, mean age of 55.5 years+/-11.4 S.D.) with chronic polyarthritis (rheumatoid arthritis (RA): nine, ankylosing spondylitis: one; psoriatic arthritis: one, unclassified: one) were included. All presented with one (7 patients) or two (5 patients) painful hindfeet (and swelling for 16 out of 17 hindfeet). On physical examination, 25 joints and eight tendons were adjudged to have synovitis and tenosynovitis. MRI showed synovitis in 12 out of 25 of these joints (48%), and tenosynovotis in three out of eight of these tendons (37.5%). Moreover, MRI showed ten and seven clinically unsuspected synovitis and tenosynovitis, respectively. The proportion of agreements between physical examination and MRI were 54.9% (kappa=0.1) and 88.2% (kappa=0.27) for synovitis and tenosynovitis, respectively. CONCLUSION: A weak correlation was observed between the findings of physical examination and MRI in patients with chronic polyarthritis and a painful hindfoot. MRI might be used to localise synovitis in the area before performing some intra-articular injections. However, other studies are needed to address this question.

Adult↗

PubMed1993

Intratendinous ganglia of the hand.

We report a series of seven patients with 10 intratendinous ganglia that were treated operatively. One ganglion was in the abductor pollicis longus tendon. The rest were in tendons of the fourth extensor compartment, and all of them were associated with tenosynovitis. The average age of the patients at operation was 55 years. One patient was treated by resection of the tendon with tendon transfer. The other patients were treated by excision of the ganglion with repair of the tendon or tenosynovectomy. The mean length of postoperative follow-up time was 6 years. One patient experienced a recurrence. Three of the six patients with preoperative dorsal tenosynovitis had tenosynovitis postoperatively. We speculate that the ganglia arose secondary to tenosynovitis. When an intratendinous ganglion is diagnosed, tenosynovectomy is recommended, with resection of the intratendinous ganglion and longitudinal tendon repair when needed.

Adult↗

PubMed1993

[Tenosynovectomy of the flexors in rheumatoid polyarthritis. Analytic study of short term and long term mobility of the fingers].

Between 1970 and 1988, 115 patients with rheumatoid arthritis underwent flexor tenosynovectomy. Fifty patients were reviewed (64 hands). The diagnosis of flexor tenosynovitis remains a clinical diagnosis. Three main groups can be distinguished: isolated carpal tenosynovitis (20%), palmodigital tenosynovitis (50%), diffuse tenosynovitis (30%). Standard surgical techniques were used, particularly in terms of the incisions. All patients underwent rehabilitation in the same rehabilitation centre. The authors analyse their results by comparing overall preoperative and postoperative mobility of the fingers (TAM: Total Active Motion, TPM: Total Passive Motion) and the angular gain in each joint (MCP, PIP, DIP). They report the results obtained at 4 months to eliminate the bias related to progression of the disease. The long-term results (8 years of follow-up) are also analysed. Statistical analysis compares two groups depending on whether flexor tenosynovectomy was isolated (44%) or combined with a dorsal surgical procedure at the same operation (extensor synovectomy, articular synovectomy, stabilisation-realignment of the dorsal aspect of the wrist, resection of the ulnar head) (56%). Ninety percent of patients declared themselves to be subjectively improved. Objectively, mobility was always improved at 4 months then deteriorated to return to its preoperative level at 8 years. Only three patients were reoperated for recurrence. Flexor tenosynovectomy in rheumatoid arthritis is an excellent operation. Its analgesic effect is maintained in time and, when performed early, it appears to protect the patient from the risk of subsequent tendon rupture.

Adult↗

PubMed2006

Arthritis as presenting manifestation of pure neuritic leprosy--a rheumatologist's dilemma.

OBJECTIVES: Leprosy classically presents with cutaneous and neurological manifestations. In diagnosed cases of leprosy, rheumatological involvement varies from 1% to 70%. A primary articular presentation without cutaneous manifestations is not yet known. Herein, we present our experience of five cases of leprosy that presented with predominant articular involvement in the absence of cutaneous manifestations. METHODS: The study was conducted in the Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences located in the state of Uttar Pradesh, one of the nine endemic states in India. Case records of patients with a definite diagnosis of leprosy were screened for the presenting manifestations, pattern of articular involvement, tenosynovitis, neurological signs and symptoms. Reports of nerve conduction study (NCS), nerve and synovial biopsy and other diagnostic tests were retrieved from laboratory records. Available radiographs were examined for evidence of juxta-articular osteopenia and erosions. RESULTS: Case records of 11,740 patients were screened, of which 28 had a diagnosis of leprosy. Twenty patients had presented with rheumatological complaints primarily. Five of the patients who presented with inflammatory arthritis with/without tenosynovitis (n = 4) and tenosynovitis alone (n = 1) had pure neuritic leprosy. All of these patients had thickened peripheral nerves and abnormal NCS. Sural nerve biopsy confirmed the diagnosis of leprosy in all these cases. CONCLUSION: A combination of tenosynovitis and thickened nerves in association with symmetric polyarthritis should raise a suspicion of leprosy even in the absence of cutaneous features.

Adult↗

PubMed1999

Endoscopic examination of the tarsal sheath of the lateral digital flexor tendon in horses.

This study was designed to develop a reliable technique for endoscopic examination of the tarsal sheath of the lateral digital flexor tendon of horses. The anatomy of the tendon sheath and associated structures was studied in detail in cadavers before determining portals for the insertion of an arthroscope into the sheath. Approaches into the sheath through the proximal pouch and through the flexor retinaculum, at the level of the sustentaculum tali, were performed and compared in cadavers. The proximal pouch portal permitted visualisation only of the proximal half of the sheath, while the approach through the retinaculum allowed examination of the entire sheath. The normal endoscopic appearance of the tarsal sheath was studied. The endoscopic approach was subsequently used to examine and treat 5 horses with tarsal sheath tenosynovitis, including 2 cases of chronic, traumatic tenosynovitis and 3 of subacute septic tenosynovitis. Four of these horses had fragmentation of the sustentaculum tali. The technique allowed adequate examination of the sheath and debridement of adhesions and lesions within the lumen of the sheath. Fragments dorsal to the medioplantar edge of the sustentaculum tali could not be visualised endoscopically and had to be removed after widening of the wound. All 5 horses survived. Follow-up enquiries (8-31 months) revealed that the horses were all reported to be sound. Four were performing at their previous level of activity, 1 was used for hacking. The 2 cases presented with chronic tenosynovitis had residual sheath distension with no associated loss of function. A prospective study, including longer term follow-up investigation, is currently being performed.

Animals↗

PubMed1996

Ultrasonographic imaging of pathology of the digital flexor tendon sheath in cattle.

The clinical, radiographic, ultrasonographic and exploratory centesis findings in 33 cattle suffering from a septic tenosynovitis of the digital flexor tendon sheath are described. Forty-one digital flexor tendon sheaths were affected: 13 of the cattle had a unilateral and eight had a bilateral septic tenosynovitis, and in the other 12 cattle with unilateral tenosynovitis one or more of the digital joints were also involved. The distended compartments of the digital flexor tendon sheath and the affected digital joint recesses could be determined accurately by ultrasonography. Depending on the type of inflammation (serous, fibrinous or purulent) the compartments and recesses were filled with anechoic, heterogeneous hypoechoic or echogenic inflammatory content. Flow-phenomena could be observed when there were effusions of liquid into the synovial cavities. Ultrasonography provided accurate preoperative details of the pathological changes to the affected tendon sheaths and the adjoining digital joints. The characteristic ultrasonographic features of septic tenosynovitis of the digital flexor tendon sheath are described.

Animals↗

PubMedDate not supplied

Trigger digits: diagnosis and treatment.

Stenosing tenosynovitis of the thumb and fingers is a very common problem seen by the primary-care physician, the orthopaedic surgeon, and the hand surgeon. Primary stenosing tenosynovitis is usually idiopathic and occurs more frequently in middle-aged women than in men, but can be seen even in infancy. Secondary stenosing tenosynovitis of the digits can occur in patients with rheumatoid arthritis, diabetes mellitus, gout, and other disease entities that cause connective tissue disorders. The diagnosis of triggering digits is generally not subtle and can be made on the basis of an adequate clinical examination. Classification according to the type of tenosynovitis and the time from onset of symptoms may be prognostically significant and may also affect the treatment outcome. As many as 85% of triggering fingers and thumbs can be treated successfully with corticosteroid injections and nonsteroidal anti-inflammatory drugs. Surgical release is generally indicated when nonoperative treatment fails. Percutaneous A1 pulley release can now be performed safely as an office procedure.

Adrenal Cortex Hormones↗

PubMed2002

Evidence for synovitis in active polymyalgia rheumatica: sonographic study in a large series of patients.

OBJECTIVE: To determine the frequency and localization of synovitis and enthesitis in patients with active, untreated polymyalgia rheumatica (PMR) by ultrasonography (US). METHODS: Polyarticular sonographic evaluation was carried out in 50 consecutive patients with PMR at disease onset. Results were compared with 50 consecutive patients with seronegative spondyloarthropathies (SpA) and 50 with seronegative and seropositive rheumatoid arthritis (RA) at disease onset. RESULTS: Synovitis and/or effusion was detected, in at least one joint, in 100% of patients with PMR. The most frequent alterations observed in patients with PMR were effusion in the subacromial-subdeltoid (SA-SD) bursa in 70% of patients, tenosynovitis of the long head of the biceps tendon (LHBT) in 68%, glenohumeral joint effusion in 66%, tenosynovitis of the flexor tendons in the carpal tunnel in 38%, radiocarpal effusion in 18%, wrist extensors tenosynovitis in 18%, coxofemoral joint effusion in 40%. knee effusion in 38%, and ankle effusion in 10%. Enthesitis and tendonitis of the anchoring tendons were relatively rare in all the articular sites. Comparison of the SpA and PMR patients showed that enthesitis (mostly in the elbow, knee, and heel) was significantly more frequent in SpA. There was a significant difference in glenohumeral and coxofemoral effusion between the PMR and SpA patients (66% vs 16% and 40% vs 14%, respectively). Comparison of PMR and RA patients showed no significant difference in the involvement of entheses, shoulder, hip, or wrist flexor tendons in the carpal tunnel. Synovitis of the elbow, knee, and wrist was significantly more frequent in the SpA and RA patients than in those with PMR. CONCLUSION: Synovitis was detected in at least one site in 100% of patients with PMR. SA-SD bursitis, LHBT tenosynovitis, carpal tunnel syndrome, and glenohumeral, knee and hip synovitis were the most frequent alterations in PMR. Enthesitis was relatively rare at any articular site.

Age Factors↗

PubMed1997

Toe dactylitis in patients with spondyloarthropathy: assessment by magnetic resonance imaging.

OBJECTIVE: To investigate using magnetic resonance imaging (MRI) the part played by flexor and extensor tenosynovitis and synovitis of the metatarsophalangeal (MTP), proximal interphalangeal (PIP) and distal interphalangeal (DIP) joints in producing the "sausage-like" aspect of spondyloarthropathy (SpA) toe dactylitis. METHODS: Twelve sausage-like toes and corresponding contralateral toes of 7 consecutive patients meeting Amor criteria for SpA were studied by MRI. RESULTS: All dactylitic toes showed fluid collections in the flexor synovial sheaths on MRI. Due to the sheath distension the plantar bone to skin distance was significantly increased (p < 0.05) in the dactylitic toes compared to normal contralateral toes. Peritendinous soft tissues were not involved since these were significantly thicker (p < 0.05) in normal toes. Extensor synovial sheaths were involved in only 4 dactylitic toes. Of the 36 joints of the 12 dactylitic toes only 2 MTP joints showed capsule distension. Considering MRI as the "gold standard", examination showed 100% sensitivity and specificity for flexor sheath involvement but lacked sensitivity for extensor synovial sheaths and showed a low specificity for joint capsule distension. CONCLUSION: Like finger dactylitis, toe dactylitis may also be due to flexor tenosynovitis and synovitis of MTP, PIP, and DIP joints may not be a required condition for sausage-shaped appearance. Extensor tenosynovitis may be present in addition to flexor tenosynovitis. Physical examination is a sufficient method for diagnosing toe dactylitis.

Adult↗

PubMed2003

Jaccoud's arthropathy in systemic lupus erythematosus: differentiation of deforming and erosive patterns by magnetic resonance imaging.

OBJECTIVE: To evaluate alterations of the soft tissues, tendons, and bones as detected by magnetic resonance imaging (MRI) in patients with systemic lupus erythematosus (SLE)-associated arthritis of the finger joints. METHODS: Both hands of 14 patients with SLE of various activities and durations and with arthritis and/or deformities of the finger joints were examined by MRI and conventional radiography. Coronal T1-weighted spin-echo (with and without gadolinium contrast), axial T2-weighted turbo spin-echo, coronal fat-suppressed short tau inversion recovery, and 3-dimensional double-echo steady-state sequences were acquired and analyzed, and the findings were compared with those from conventional radiographs. RESULTS: MRI detected periarticular capsular swelling in all 14 patients, joint effusion in 7, edematous tenosynovitis in 6, proliferative tenosynovitis (flexor and/or extensor tendons) in 4, and intraarticular signs of synovial membrane hypertrophy in 10 patients, 9 of whom showed enhancement after administration of contrast medium. Bony erosions were identified in 8 patients by MRI; conventional radiography missed these erosions in 2 of the 8 patients. Four of the 14 patients were designated as Jaccoud's arthropathy index-positive, and all 4 showed severe edematous tenosynovitis and capsular swelling, but no signs of bony erosions despite longstanding disease (mean 21.5 years). Four of the 10 patients with mild deformity exhibited prominent soft tissue pathology, with minimal destruction of bone; the other 6 patients had bony alterations that resembled rheumatoid arthritis. CONCLUSION: In SLE patients with arthritis of the finger joints, MRI detects characteristic signs of soft tissue pathology (e.g., capsular swelling, edematous and proliferative tenosynovitis, synovial hypertrophy) and bony alterations (e.g., erosions, some of which are missed by conventional radiography). MRI thus helps to distinguish different types of lupus arthritis/Jaccoud's arthropathy, which allows more differentiated treatment strategies and monitoring.

Adult↗

PubMed2004

Magnetic resonance imaging of the wrist in rheumatoid arthritis: demonstration of progression between 1 and 6 years.

OBJECTIVE: To describe the changes seen in the wrist in rheumatoid arthritis (RA) on magnetic resonance (MR) imaging obtained at 1 year and 6 years. DESIGN: A cohort of patients with RA has been studied prospectively from symptom onset. PATIENTS: MR scans of the dominant wrist in 31 patients obtained at 1 year and 6 years were compared for bone erosions, marrow signal change (oedema), synovial thickness and tenosynovitis. RESULTS: Twenty-two patients had an increase in erosion score in the interval and three patients showed a decrease in erosion score suggesting erosion healing. Fourteen patients had an increase in oedema score in the interval and eight patients had a decrease in oedema score. Synovial thickness increased in 13 patients and decreased in eight. Tenosynovitis increased in 15 patients and decreased in five. Bone erosions developed immediately adjacent to the tenosynovitis in two patients. CONCLUSIONS: MR imaging is useful in following the progress of bone erosions, marrow oedema, synovitis and tenosynovitis in RA.

Adult↗

PubMed2005

MR imaging findings in hands in early rheumatoid arthritis: comparison with those in systemic lupus erythematosus and primary Sjögren syndrome.

PURPOSE: To evaluate prospectively the use of magnetic resonance (MR) imaging for differentiating true rheumatoid arthritis (RA) from systemic lupus erythematosus (SLE) or primary Sjögren syndrome in patients who have inflammatory polyarthralgia of the hands but no radiographic evidence of RA. MATERIALS AND METHODS: This study had institutional review board approval, and patient informed consent was obtained. Twenty-eight patients (16 female and 12 male patients; mean age, 42 years) with early RA and 19 patients (18 female and one male patient; mean age, 46 years) with SLE (n = 14) or primary Sjögren syndrome (n = 5) underwent MR imaging of both hands. All patients had inflammatory polyarthralgia of the hands and no evidence of erosive changes on radiographs. Coronal T2-weighted short inversion time inversion-recovery, transverse T1-weighted spin-echo, transverse fat-suppressed gadolinium-enhanced T1-weighted spin-echo, and transverse gadolinium-enhanced three-dimensional gradient-echo MR images were obtained. The following MR imaging variables were assessed in the wrist and nonthumb metacarpophalangeal joints: synovitis, bone lesions (erosion, defect, and edema), and tenosynovitis. Synovitis and bone lesions were scored with the OMERACT RA-MRI scoring system. Findings in patients with RA and those without RA were compared by means of Mann-Whitney, chi2, and Fisher exact tests. RESULTS: The only significant difference between the two groups in terms of individual scores for synovitis, bone lesions, and tenosynovitis was the more frequent presence of tenosynovitis of the right fourth extensor tendon in patients without RA (P = .04). There were no significant differences between patients with RA and those without RA in terms of global scores for synovitis, bone lesions, and tenosynovitis. However, bone marrow edema in the metacarpophalangeal joints was seen more frequently in patients with RA (P < .001). CONCLUSION: It may be impossible to distinguish between patients with early RA and those without RA (ie, those with SLE or primary Sjögren syndrome) by means of MR imaging.

Adolescent↗

PubMedDate not supplied

How normal are the hands of normal controls? A study with dedicated magnetic resonance imaging.

OBJECTIVE: To investigate bone and soft tissue changes in the hands of normal subjects by MRI. METHODS: Twenty-three normal volunteers (16 women) agreed to be examined. MRI of the hand was performed with a dedicated-extremity 0.2 Tesla device using gradient echo, spin echo and STIR sequences. Joint space width was measured in 16 different locations of the hand. Bone lesions, including bone oedema, ankylosis, and erosions, as well as the presence of tenosynovitis were investigated. RESULTS: Reproducibility of measures of joint space width was relatively good with an intraclass correlation coefficient of 0.82 and 0.71 in the intra-observer and inter-observer evaluations, respectively. No age- or sex-related differences of joint space were observed. Reproducibility of the readings of bone oedema and tenosynovitis were optimal. Bone oedema and erosions were observed in 2/23 (8.7%) and in 6/23 (26.1%) subjects, respectively. Tenosynovitis of the extensor tendons was present in 1/23 subjects (4.3%), whereas tenosynovitis of the flexor tendons was seen in 4/23 (17.4%). CONCLUSION: This study demonstrates that joint changes considered to be peculiar of arthritis can be found by MRI in a relevant percentage of healthy subjects. Our data suggest that a control group of healthy subjects should be included in MRI studies on the appearance of the wrist in disease.

Adult↗

PubMed1995

[The role of magnetic resonance imaging with a low-intensity field (0.2 T) in assessing expansive lesions of the hand and wrist].

The diagnostic capabilities of a small-size low-field (0.2-T) MR unit with a dedicated coil were investigated in the study of expansive lesions of the hand and wrist. Twenty-five patients suffering from the following diseases were examined: synovial cyst (6 patients), ganglion cyst (4), acute suppurative tenosynovitis (3), stenosing tenosynovitis (2), arteriovenous fistula (1), lipoma (1), fibrolipoma (2), chondroma (1), glomus tumor (1), fibromatosis palmaris (3), villonodular synovitis (1). Spin Echo (SE) and Gradient Echo (GE) scans were performed on all patients. The MR findings were compared with US, surgical and pathologic results. In synovial and ganglion cysts, acute suppurative and stenosing tenosynovitis, fibromatosis palmaris, fibrolipoma and lipoma, MRI showed typical patterns. In arteriovenous fistula, chondroma, glomus tumor and villonodular tenosynovitis, an accurate diagnosis could not be made: in these cases US failed to yield unquestionable results and the lesions could be diagnosed only at pathology. MRI yielded very accurate information as to lesion site and relationship with the surrounding structures; this kind of information, which is extremely important for the surgical approach, is not always provided by US. Low-field MRI can be considered a valuable diagnostic tool in the study of some expansive lesions of the hand and wrist. In other lesions this method can play a major role for both their characterization and the surgical approach.

Adolescent↗

PubMed1996

Dactylitis in patients with seronegative spondylarthropathy. Assessment by ultrasonography and magnetic resonance imaging.

OBJECTIVE: To establish by means of ultrasound and magnetic resonance imaging (MRI) the role of tenosynovitis and arthritis in determining the "sausage-like" aspect of finger dactylitis and to compare the results of the 2 examinations. METHODS: Twelve dactylitic fingers and their corresponding normal contralateral fingers belonging to 10 patients who met the Amor criteria for the diagnosis of seronegative spondylarthropathy (SpA) were studied by ultrasonography and MRI. RESULTS: MRI revealed a significant increase in the volar bone-to-skin distance in dactylitic fingers with respect to that of the normal contralateral fingers (P < 0.001). This increase was due to distension of the flexor synovial sheaths (P < 0.00001) by fluid collection. Peritendinous soft tissues were not involved, since these were found to be significantly thicker in the normal fingers (P < 0.05). Of the 36 joints of the 12 dactylitic fingers, only 1 showed capsule distension. Using MRI as the "gold standard," ultrasonography showed a 100% sensitivity and specificity for flexor tenosynovitis, but lacked sensitivity for joint involvement because it failed to reveal joint capsule distension in the only joint involved. Similarly, physical examination showed a 100% sensitivity and specificity for flexor sheath involvement. CONCLUSION: Dactylitis is due to flexor tenosynovitis. Enlargement of the finger joint capsule is not an indispensable condition for the "sausage-like" feature. Physical examination is a sufficient method for the diagnosis of dactylitis.

Fingers↗