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PubMedDate not supplied

[Direct endoscopic approach improves prognosis of septic-synovitis in the horse].

The medical records of 71 horses with sepic arthritis, bursitis, or tenosynovitis, treated between 1996 and 2001 at Dierenkliniek Enmeloord, were reviewed. A total number of 81 joints, tendon sheaths and bursae were treated (21 tarsi, 17 digital tendon sheaths, 14 metacarpo/metatarso-phalangeal joints, 12 stifles, 6 carpi, 4 coffin joints, 2 navicular bursae, 1 elbow joint, 1 proximal-interphalangeal joint, 1 tarsal sheath, 1 bursa calcanei subtendineum). The aetiology in 42 cases was a penetrating wound (group 1), in 4 cases an intra-articular injection, and in 2 cases arthroscopic surgery (group II), and in 13 cases septic arthritis in young foals (group III); in 10 cases the aetiology was unknown (group V). A total of 93 endoscopic lavages was performed on 81 joints, tendon sheaths, and bursae (1-3 lavages, mean 1.18 lavage per synovial structure). Survival rates were 95% for group I, 100% for group II, 73% for group III and 100% for group IV. Horses were discharged after 4-73 days of hospitalization (mean 20 days). Longterm follow-up revealed a survival rate of 92% for group I, 100% for group II, 67% for group III, and 90% for group IV. Of the surviving horses, 89% were sound and 11% had some degree of residual lameness. It is concluded that instant aggressive treatment using endoscopic techniques yields the best results so far and is therefore recommended.

Animals↗
PubMed2002

[Imaging of osteoarticular tuberculosis].

PURPOSE: and methods. To perform an illustrated and educational review of musculoskeletal tuberculosis. RESULTS: As the incidence of musculoskeletal tuberculosis still increases, a review appears justified. The following four main presentations are detailed and illustrated, by emphasizing the value of both CT and MR imaging: a) spine tuberculosis (~ 50%) commonly involves two adjacent vertebral bodies with usual large paravertebral abscesses. The following lesions are highly suggestive of tuberculosis: solitary vertebral involvement, solitary epidural abscess with or without erosive spondylitis; b) osteo-arthritis: peripherally located erosions at synovial insertions with gradual narrowing of the joint space are highly suggestive; c) osteomyelitis: unusual, may involve any bones; d) tenosynovitis and bursitis. CONCLUSION: Imaging studies are essential for diagnosis and to assess the extent of musculo-skeletal tuberculosis.

Bursitis↗
PubMed2003

Magnetic resonance imaging appearance of the hands and feet in patients with early rheumatoid arthritis.

OBJECTIVE: To describe the magnetic resonance (MRI) imaging findings of the feet in patients with early rheumatoid arthritis (RA), and to compare MRI appearance of the feet with that of the hands. METHODS: Thirty consecutive patients (18 women, 12 men; age range 19-64 yrs) with early RA underwent MRI of hands and feet. Axial fat suppressed gadolinium enhanced T1 weighted spin-echo and gadolinium enhanced 3-dimensional gradient-echo (FLASH) images were obtained. RESULTS: In the hands, MRI findings suggested active synovitis of the wrist and metacarpophalangeal (MCP) joints in 28 (93%) and 27 (90%) patients, respectively. In the feet, active synovitis was observed in 29 (97%) patients. Bone erosions were seen in the wrist joints in 24 (80%) patients. Observers found as many bony changes in the MCP as in the metatarsophalangeal joints [23 (77%) patients]. MRI detected tenosynovitis in 16 (53%) patients in the hands, and in 18 (60%) patients in the feet. Bursitis located between or beneath the metatarsal heads was a common MRI finding [19 (63%) patients]. CONCLUSION: Additional MRI of the feet may be useful when evaluation of the hands does not help identify early RA.

Adult↗
PubMed1976

[Experimental "hormonal tenolysis" by cortisone therapy (author's transl)].

To prevent tendons from postoperative proliferation and adhesion to surrounding structures is still a main problem in handsurgery. In addition to numerous modifications of atraumatic handsurgical techniques which have been developed some sporadic attempts are made by animal experiments and clinical trials in order to avoid postoperative adhesive tenosynovitis by hormone therapy. Because of the high doses of cortisone which are required this method of treatment is generally not accepted. Using a new method of postoperative fixation of flexor tendon sutures in rabbits the possibility of a "hormonal tenolysis" by extremely high doses of cortisone could be confirmed. In a following study it is planned to perform breaking experiments on tendons after hormone therapy in order to determine the upper limit of the therapeutical range of cortisone medication.

Animals↗
PubMed1960

Common granulomatous inflammations of the extremities.

Granulomatous inflammatory diseases of the extremities caused by inanimate agents (physical or chemical) and agents of unknown character are frequently unrecognized. The symptoms produced by these lesions are too frequently ascribed to trauma, particularly an insignificant bruise or imagined microtrauma. None of the rheumatic diseases-tenosynovitis, myositis, bursitis, fibrositis, gout, rheumatoid arthritis and osteoarthritis-has ever been created by slight or severe mechanical trauma in experimental animals or human beings.

Animals↗
PubMed1992

Peroneal tendon subluxation in a case of anomalous peroneus brevis muscle.

We report a case of peroneal tendon subluxation as a result of an anomalous extension of the peroneus brevis muscle into the fibular groove, causing an encroachment phenomenon, stretching-out of the superior peroneal retinaculum, longitudinal splitting of the peroneus brevis tendon, subluxation of the peroneal tendons, and peroneal tenosynovitis. We describe a simple surgical technique for tendon stabilization, after decompression of the fibular groove.

Adult↗
PubMedDate not supplied

Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome in Nagano, Japan: clinical, radiological, and cytokine studies of 13 patients.

OBJECTIVE: Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) has so far been reported almost exclusively from the USA and Europe. We carried out this study to define the clinical characteristics of this syndrome in Japanese patients. METHODS: Prospectively, we identified 13 Japanese patients with RS3PE (5 men and 8 women, age 72.7 +/- 11.8 years (mean +/- SD)) without underlying neoplasm. Their clinical features were summarized, pertinent laboratory data including serum/synovial interleukin-6 (IL-6) concentrations were obtained, and extensive radiologic studies using magnetic resonance imaging and 67gallium-citrate (67Ga) whole body scintigram were performed. RESULTS: All patients suffered from proximal arthralgia/myalgia in addition to typical distal symptoms of RS3PE, and all experienced systemic symptoms such as fever, malaise, and weight loss. In laboratory examinations, anemia and elevated inflammatory markers were often remarkable. Magnetic resonance imaging showed severe tenosynovitis of the hands. 67Ga-scintigram revealed radioisotope accumulation in both proximal and distal joints of the extremities. IL-6 activity was markedly elevated both in the serum (mean 82.4 +/- 62.1 (SD) pg/ml, normal range 0.157-2.94) and in the synovial fluid (mean 3350 +/- 633 (SD) pg/ml). CONCLUSION: Compared with cases reported previously from the USA/Europe, Japanese patients with RS3PE are characterized by more prominent systemic symptoms/signs associated with marked inflammatory responses including elevated IL-6 activity. All patients had proximal as well as distal synovitis which could be demonstrated by 67Ga-scintigram. These clinical features were very similar to those of polymyalgia rheumatica, suggesting that RS3PE and polymyalgia rheumatica are closely related disorders which may have a common pathogenesis.

Aged↗
PubMed2004

Paraneoplastic polyarthritis in an ovarian teratoma.

A 34-year-old woman presented to the rheumatology clinic with severe low back pain and arthralgia; later she developed bilateral knee pain and swelling, with limitation in ambulation and minimal improvement with nonsteroidal antiinflammatory drugs. Two weeks later she developed pain on the volar aspect of the right wrist and on the hypothenar region of the right hand. Examination showed swelling and tenderness of the right hypothenar region, tenderness and decreased flexion and extension of the right wrist, and bilateral knee effusions. The combination of arthritis and tenosynovitis raised the possibility of an ovarian tumor. A pelvic ultrasound revealed a complex, hyperechoic ovarian mass consistent with a cystic teratoma. Four weeks after removal of the teratoma, the polyarthritis and related symptoms resolved without therapy.

Adult↗
PubMedDate not supplied

Hand abnormalities of the patients with diabetes mellitus.

Hand abnormalities, represented by Dupuytren's contracture, limited joint mobility, carpal tunnel syndrome, flexor tenosynovitis,occur in approximately 50% of the diabetic patients, affecting their activity and decreasing the quality of their life. Using specific methods, these can by detected long before they are observed by the patients. These disturbances have a high prevalence inthe persons with long diabetes mellitus duration, the prevalence increasing with the age. Smoking, usual hard activities, bad metabolic control and so on, can increase the severity of these disturbances. It is compulsory a careful examination of the patients' hands, because more abnormalities can be surgically rightened.

Carpal Tunnel Syndrome↗
PubMed2006

Single side hole irrigation--a simple method of catheter irrigation of the tendon sheath.

Treatment of septic flexor tenosynovitis at the hand requires significant hospital resources in terms of operative time and subsequent management of tendon irrigation. Delayed recovery or treatment failure may require re-irrigation and drainage. This may be due to failure to adequately irrigate the entire flexor sheath. We describe a method of closed tendon sheath irrigation which is simple to use and ensures that the complete tendon sheath is adequately irrigated. Unwieldy continuous irrigation is avoided and patient inconvenience is kept to a minimum.

Anti-Bacterial Agents↗
PubMed2006

[Treatment algorithm in synovial tuberculosis of the hand and wrist: a report of three cases].

Three patients with synovial tuberculosis are presented. Involvement was in the hand in one patient, and in the wrist in two patients. None of the patients had pulmonary tuberculosis or a family history of tuberculosis. Tuberculosis treatment was initiated only after histologic verification. The cultures remained negative. The patients received a 12-month course of multidrug chemotherapy for tuberculosis, resulting in symptomatic improvement and healing. There were no recurrences during a follow-up period of 16 to 26 months. Our clinical observations showed that tuberculosis tenosynovitis benefited well from antituberculosis chemotherapy.

Adolescent↗
PubMed2006

[References to avoid complications in releases of the trigger thumb: a cadaveric study].

OBJECTIVES: The aim of this cadaveric study was to demonstrate the utility of some visible landmarks in the hand in avoiding probable complications during percutaneous or open releases performed for the trigger thumb associated with flexor tendon tenosynovitis. METHODS: In this cadaveric study, we dissected 20 thumbs of 10 fresh cadavers (10 males; mean age 46 years; range 31 to 62 years) from the interphalangeal to the metacarpophalangeal creases to expose all digital arteries, nerves, the flexor tendon, and the A1 pulley. The following distances were measured: from the proximal edge of the A1 pulley to the digital arteries and nerves, and to the interphalangeal and metacarpophalangeal creases of the thumb. RESULTS: The proximal edge of the A1 pulley lies at a mean distance of 3.5 mm distal to the metacarpophalangeal crease, and about 35 mm distal to the interphalangeal crease. These values may be helpful during percutaneous releases in avoiding any injury to the radial digital nerve, which crosses the flexor tendon proximal to the A1 pulley. On the other hand, care should be taken for the ulnar digital nerve during open releases, which is at a higher risk than the radial digital nerve due to its closer proximity to the A1 pulley, the mean distances being 1.95 mm and 3.40 mm, respectively. CONCLUSION: These data are helpful in avoiding injuries to the digital nerves, which imply that the digital nerve on the ulnar side of the A1 pulley is more vulnerable during open releases, while the radial digital nerve proximal to the metacarpophalangeal crease is more vulnerable during percutaneous attempts. Complications can be avoided if the interphalangeal and palmar creases are taken into consideration.

Adult↗
PubMed1991

Upper extremity wound management: intermediate infections.

A careful history and physical examination, including information regarding position of the hand at the time of injury, presence of other disease, handedness, age, and occupation, are all essential to evaluate hand infection. If surgery is anticipated, antibiotics should generally be withheld until operative cultures are obtained. Infections secondary to human bite injuries are common and are usually caused by a blow of the fist to the mouth. These injuries can produce crippling sequelae, must be managed promptly and aggressively, and often require surgery. Flexor tenosynovitis, often caused by a penetrating injury, may be treated nonoperatively if the patient presents within 24 to 48 hours of onset. Older injuries always require incision and drainage of the flexor tendon sheath. Most authors agree that surgical management of dog bite wounds to the hand is essential. Cat and arthropod bites may also require surgery.

Bites and Stings↗
PubMedDate not supplied

Efficacy of coarse-spray administration of a reovirus vaccine in young chickens.

Coarse-spray (CS) administration of a commercial S1133 reovirus vaccine in chickens for prevention of clinical viral tenosynovitis (VT) infection was evaluated. In Expt. 1, one-day-old specific-pathogen-free (SPF) white leghorns were vaccinated with a combination of reovirus, Newcastle disease (ND), and infectious bronchitis (IB) vaccines by CS and infectious bursal disease vaccine by the subcutaneous (SQ) route. In Expt. 2, one-day-old commercial broilers were vaccinated by CS with reovirus vaccine and Marek's disease (MD) vaccine by SQ. In Expt. 3, one-day-old commercial broilers received reovirus vaccine in combination with ND-IB vaccines at 1 day of age by CS and MD vaccine by SQ. Some birds received an initial or second vaccination at 7 days of age by CS or the drinking-water (DW) route. Birds vaccinated by CS at 1 day of age with reovirus vaccine did not produce circulating virus-neutralizing antibody against reovirus, although they had resistance to VT infection. In contrast, initial or booster vaccination at 7 days of age by CS or DW resulted in an antibody response and greater resistance to challenge than did CS vaccination at 1 day of age. There was no difference in efficacy between CS and DW routes at 7 days of age. The reovirus vaccine did not interfere with other vaccines as measured by serologic (ND-IB-IBD) or challenge (MD) studies.

Administration, Intranasal↗
PubMed1991

Trigger thumb in children: results of surgical correction.

Stenosing tenosynovitis of the thumb, or trigger thumb, is relatively uncommon in children. The surgical correction of trigger thumb in 15 children is described to illustrate the clinical features of this condition. The literature is reviewed in order to alert the orthopaedic surgeon to the natural history of triggering digits in childhood.

Child↗
PubMed1991

[Symptoms in area of the Achilles tendon. Etiology and therapeutic considerations].

A number of pathologic conditions can produce posterior heel pain, making it difficult to distinguish the exact cause. Only a careful physical examination allows the probable diagnosis, which is the first and most important step in a successful therapy. Pathologically, the Achilles tendon itself may be inflamed secondary to degeneration owing to a decreased blood supply or the result of a partial rupture. The inflammation can also be accompanied by microtears or calcium deposits. In most cases the tendon sheath and the mesotenon are also involved (tenosynovitis). The retrocalcaneal bursa located between the posterior angle of the os calcis and the Achilles tendon may become inflamed and hypertrophic. It is frequently associated with a prominent superior tuberosity of the os calcis. In a few cases there was also an irritation of the bursa between the Achilles tendon and the skin caused by ill-fitting shoes. Over a 3-year period, 102 patients who engaged in different sports were treated for problems in the Achilles tendon area and retrospectively reviewed with a follow up of 18.8 months. Most of them were runners (48%), followed by soccer players (15.7%) and tennis players (5.9%). The mean age was 36 years. In the vast majority of patients (n = 70, 68.6%) nonoperative treatment was successful. In this group there were 45 cases (65%) with postural abnormalities and excessive pronation requiring correction by means of orthotic appliances. In 19 patients (27%) the problems were caused by a muscular imbalance, and in 15 cases (21%) wrong training methods with overuse had caused the inflammation.(ABSTRACT TRUNCATED AT 250 WORDS)

Achilles Tendon↗
PubMed1990

[Sonography of the wrist and the hand].

Sonographic examination of the hand requires high-frequency linear transducers. As the relevant structures are located very close to the surface, water stand-off pads are mandatory. Owing to the high sensitivity of sonography in the detection of fluid, exudative synovitis, tenosynovitis and ganglia can be easily diagnosed. Sonographic information on muscle atrophy and alterations of the shape and echogenicity of the median nerve in patients with carpal tunnel syndrome may be useful in evaluating the extent of disease. Further indications for the sonographic examination of the hand include suspected tumors, foreign bodies and synovial proliferation. Osseous destruction can be visualized in patients with rheumatoid disease, but the precise extent is hard to determine.

Arthritis↗