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PubMed1985

Cheiralgia paresthetica and linear atrophy as a complication of local steroid injection.

Cheiralgia paresthetica, a mononeuropathy of the superficial branch of the radial nerve, is an uncommon problem, usually resulting from local trauma to the wrist. This report describes a 27-year-old patient who developed subdermal atrophy following local hydrocortisone injection as a treatment for deQuervain's tenosynovitis. Subsequently, she developed linear skin atrophy, a rare complication of steroid injection thought to result from lymphatic spread of the steroid suspension, extending proximally from the initial atrophic area in her hand into her forearm. Soon after wearing a wristwatch on the affected wrist, she developed symptoms of cheiralgia paresthetica. Linear atrophy was found to traverse the superficial radial nerve and was considered to contribute to the symptoms. It is important to be aware that subcutaneous atrophy may follow the lymphatics with injections of steroid.

Adult↗

PubMed1985

Occurrence of De Quervain's tendinitis during pregnancy.

Six women developed De Quervain's tenosynovitis during pregnancy. Onset was never before the fifth month. Two patients also had carpal tunnel syndrome. In two otherwise untreated patients, tendinitis resolved only after discontinuation of nursing. We discuss the possibility of association with hormonal changes occurring during pregnancy.

Adult↗

PubMed1979

De Quervain's disease.

This is a tenosynovitis of the abductor pollicis longus and extensor pollicis brevis tendons contained within the osseofibrous tunnel of the distal radius. Multiple tendons for the abductor pollicis longus and a separate, severely narrowed sheath for the extensor pollicis brevis make nonsurgical treatment difficult at times. While avoiding damage to nerve branches, surgical treatment is aimed at release of both tendon sheaths.

Humans↗

PubMed1979

Vasculitis associated with intestinal bypass surgery.

We report two cases in which necrotizing vasculitis with tenosynovitis arthralgia/arthritis syndrome developed after intestinal bypass surgery. Each of these patients had jejunoileostomies, and the excluded segment was placed in an ileal-colonic anastomosis. We speculate that since the attachment of the excluded segment to the large intestine predisposes it to increased bowel overgrowth of bacteria, these bacteria or their debris may have served as antigens for circulating immune complexes, which were detected in both patients by one or more techniques. Patients who have had an end-to-side anastomosis may be less predisposed to the more severe vasculitis syndrome because there is less likelihood of bacterial overgrowth in the bypassed intestinal segment.

Adult↗

PubMed1979

[Tenosynovectomy in rheumatoid arthritis (author's transl)].

Tenosynovitis is much more frequent in RA than supposed. A comparative statistic of joint- and tenosynovectomy of the Clinic Wilhelm Schulthess is presented. It also proves the importance of flexor tendon involvement. From the patient's point of view the result is good in more than 95% 6 years in average after synovectomy. Recurrent synovitis is very rare in the extensor tendon. It may occur in the extensor carpi ulnaris. In the flexor compartement the symptoms disappear also in most instance. The reasons are discussed and figures given of our statistic.

Adult↗

PubMed1973

Gonococcal arthritis: a report of six cases.

Six cases of gonococcal arthritis are described. Three presented during the initial "bacteremic stage" with polyarthralgia, fever, skin lesions and sterile synovial fluid. Two presented during the "septic joint stage" with positive synovial culture, and one presented during the "stage of residual deformity". Transient electrocardiographic changes were noted in two of the six cases. All responded to antibiotic therapy. One required additional surgical intervention.The condition is common, coinciding with the rising incidence of symptomatic and asymptomatic gonorrhea. Gonococcal infection must be considered in the differential diagnosis of migratory polyarthralgia, tenosynovitis, oligoarthritis, fever or unusual skin lesions. Criteria for diagnosis, lines of treatment and relevant literature are reviewed.

Adolescent↗

PubMed1979

[Unusual causes of the carpal tunnel syndrome].

In 193 cases of carpal tunnel exploration, carried out because of compression of the medium nerve, we have encountered 15 unusual findings (7.8%). This emphasizes the necessity for thorough exploration of the carpal tunnel. Four unusual disease processes are described, which led to a median compression syndrome: Tuberculous tenosynovitis, lipomatous hyperplasia, chondroma of a superficial flexor tendon and monofascicular neurinoma of the median nerve.

Adult↗

PubMed1979

The clinical features and HLA associations of reactive arthritis associated with non-gonococcal urethritis.

Fifty-seven patients with arthritis associated with non-gonococcal genital infection have been studied. Synovitis characteristically affected one or a few joints, expecially the knee, ankle or metatarsophalangeal joints and was accompanied by tenosynovitis and enthesopathies--each in about one third of the patients. A quarter of the patients had ocular, cutaneous, or mucous membrane lesions (Reiter's syndrome). Although six patients developed a chronic or relapsing course, average duration of the acute episode in the majority was three to five months. Available evidence strongly suggests that infection following sexual intercourse, usually but not always with a new partner, was instrumental in the initiation of the disease. We have suggested the term 'sexually acquired reactive arthritis (SARA)' to emphasize the mode of acquisition of the disease, and note that similar syndromes are seen associated with gut infection. We consider that usage of the term Reiter's syndrome is correctly applied to only those cases which exhibited the characteristic triad of urethritis, arthritis and conjunctivitis with or without other cutaneous and mucous membrane lesions. Thirty-six of the 54 patients who were HLA typed (67 per cent) possessed the antigen HLA-B27. Of 30 who presented directly to a rheumatology unit 25 (82 per cent) were HLA-B27 positive. The other 24 patients initially attended a venereology clinic and only 11 (46 per cent) of these bore the antigen. This appears to reflect disease severity, HLA-B27 positive patients having a significantly longer duration of disease symptoms and a higher frequency of extra-articular manifestations, than those lacking this antigen.

Adolescent↗

PubMed1983

[Granular cell myoblastoma (apropos of a case with bilateral localization in the thigh)].

Granulo-cellular myoblastoma (MGC) is a rare disease, the nature of which is still discussed and uncertain. The authors describe a particular case with bilateral location at thigh in a patient suffering also from pigmental villonodular tenosynovitis (TSVNP) at the right thumb. This observation confirms the absolute benignancy, and supports the theory of the non-neoplastic histogenesis of MGC.

Humans↗

PubMedDate not supplied

Pathogenicity for chickens of a reovirus isolated from turkeys.

A viral agent that was isolated from livers of commercial turkey poults that died at approximately two weeks of age was characterized as a reovirus. Experimental infection of day-old chickens with this reovirus isolate resulted in the development of tenosynovitis, hepatitis, and myocarditis. In vitro neutralization of the turkey reovirus isolate by antiserum against chicken reovirus correlated with in vivo protection of maternally immune chickens from day-old oral challenge with the turkey reovirus isolate.

Animals↗

PubMedDate not supplied

Development of an attenuated apathogenic reovirus vaccine against viral arthritis/tenosynovitis.

A fully attenuated apathogenic reovirus vaccine was developed by 235 serial passages of S1133 strain avian reovirus in embryonating chicken eggs and 100 additional passages in chicken embryo fibroblast (CEF) cultures, 65 of which were cultured at 32 C. Chickens with and without maternal antibodies to avian reovirus were vaccinated subcutaneously at 1 day of age and challenged via footpad at 14 days of age. It appeared that the 40th, 66th, and 100th CEF passage levels were apathogenic at doses ranging from 10(2.5) to 10(6.8) TCID50/chick. No gross or microscopic lesions of tenosynovitis developed in vaccinated chicks. Vaccinated chicks were protected against challenge; unvaccinated control chickens were not.

Animals↗

PubMed1984

[Stenosing tendovaginitis of the flexor carpi radialis tendon].

Pain at the radial side of the wrist may be caused by stenosing tenosynovitis of the flexor carpi radialis tendon. Typical in these cases is a tenderness over the tendon at the wrist. Pain is most often produced by pronation and especially by palmar flexion against resistance. The condition is caused by narrowing of the canal of flexor carpi radialis tendon within the wrist by nonspecific synovitis. In some cases osteoarthritis of the joint between the scaphoid and trapezium can compress the tendon and cause its attrition. If the pain is not relieved by conservative methods it can usually be cured by operative decompression of the canal.

Constriction, Pathologic↗

PubMed1983

Posterior tibial tendon rupture in a world class runner.

Complete rupture of the posterior tibial tendon occurs infrequently. It can be caused by a variety of factors, including repeated steroid injections, chronic tenosynovitis, and decreased blood supply to the tendon. The authors report a world class runner who sustained a rupture requiring surgical intervention.

Adult↗

PubMed1983

Musculo-skeletal symptoms in early sarcoidosis. Twenty-four newly diagnosed patients and a two-year follow-up.

Musculo-skeletal symptoms were screened in 24 consecutive patients with newly diagnosed sarcoidosis and followed up two years later. Ten patients had joint involvement. Symptoms were most frequently found in ankle joints, followed by hand and knee joints. Arthritis was found in seven (29%) patients, two of whom suffered from monoarthritis of foot and wrist joint, respectively. Three patients had tenosynovitis. Muscle symptoms such as myalgia were present in six patients. Open biopsy of the gastrocnemius muscle showed epithelioid cell granulomatosis in nine of 20 patients. Only three of these nine patients had symptoms of myalgia, although not in the biopsied muscle. At follow-up, musculo-skeletal symptoms were found in only three patients, all of whom initially had Löfgren's syndrome.

Adult↗

PubMed1982

[Twenty-three cases of gonococcal arthritis (author's transl)].

Twenty-three cases of gonococcal arthritis involving 10 men and 13 women aged from 18-81 years (mean, 32 years) are reported. Seven of the men had developed urethritis 3 to 21 days previously. Seven of the women had no signs or symptoms of genital infection. Twelve patients presented with polyarticular lesions and 7 with monoarticular lesions heralded by migratory arthralgias. The joints most commonly affected were the knees, fingers, wrists and ankles. Ten patients had tenosynovitis of the flexor muscles of fingers, and 10 exhibited a skin rash suggestive of the condition. Haemocultures were positive for N.gonorrhoeae in 4 out of 12 patients. The organism was isolated from synovial fluid in 7/11 cases and from urethral and vaginal secretions in 9/20 cases. All patients were cured rapidly and without sequelae with penicillin or ampicillin.

Adolescent↗

PubMed1981

[Carpal tunnel syndrome in infants].

We have observed and operated on 5 children at the age of 15 months to 6 years for carpal tunnel syndrome. 4 children, all belonging to the same family had bilateral median nerve compression syndrome. These 4 children also suffered from bilateral tenosynovitis, and a mild form of mucopoolysaccharidosis (M. Scheie) was diagnosed. The symptoms in all 5 children were uncharacteristic and initially difficult to associate with nerve compression at first. Numbness and dysaesthesia in the thumb, index and middle finger, the most frequent signs in adult patients, were missing. In these children, the observation of general manual clumsiness, unusual patterns of grasping, sudden change in playing habits with avoidance of manual activity led to the suspicion of a median nerve compression syndrome. In all children decompression of the median nerve resulted in normalization or marked improvement of hand function.

Carpal Tunnel Syndrome↗

PubMed1983

Painful conditions affecting the shoulder.

Many painful conditions affect the shoulder. They can be divided into those extrinsic or intrinsic to the shoulder. The extrinsic conditions include disorders of the cervical spine and thoracic outlet, as well as postural conditions. Intrinsic lesions include acute and chronic calcific tendinitis, bicipital tenosynovitis, arthritis, and adhesive capsulitis. Each disorder has a characteristic clinical pathologic set of diagnostic features, arthrographic picture, and treatment requirements.

Arthritis↗

PubMed1978

Hand infections.

Superficial infections include paronychia, cellulitis and lymphangitis. Grave infections include felon, purulent tenosynovitis, thenar infections, septic arthritis and human bites. Treatment by incision and drainage, moist heat, elevation, splinting and specific antibiotics or other agents applies to most hand infections. When pus is found, adequate drainage usually gives good results. Without drainage, pressure necrosis and gangrene often follow. Rest for the infected part and for the patient is as important as any other facet of treatment.

Bites, Human↗