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PubMed1992

[De Quervain's tenosynovitis. Transversal scar and fixation of the capsular flap].

The authors report 62 cases of De Quervain tenosynovitis treated from 1983 to 1990 by the same surgeon. The de Quervain's tenosynovitis is an inadequation between the volume of the abductor pollicis longus and the extensor pollicis brevis and their tunnel above the radial styloid process producing a mechanical tenosynovitis. This disease occurs mostly in women with an average age of 47 and almost never before the age of 30. Clinically the patients have pain and swelling above the radial styloid process. Most of the surgeons know today this disease, nevertheless complications may occur (Abductor pollicis longus luxation, disgratious enlargement and adhesion of the scar). The transversal incision provides a less disgracious scar. As the tendinous pulley is opened frequent anatomical variations of the tendons are found. A ventral capsular flap fixation with a subcuticular continuous suture is made. This fixation prevents any ventral luxation. Radial nerve neuromas or neuritis is constantly looked for. The authors expose and analyse the statistical data of this intervention's results with a 6 month minimal and 7 years maximal follow up.

Adolescent↗
PubMed2005

The outpatient treatment of pyogenic flexor tenosynovitis.

Historically, pyogenic flexor tenosynovitis has been treated with surgical debridement followed by hospitalization and administration of intravenous antibiotics. Recently, hand surgeons have treated this disorder on an outpatient basis. We retrospectively reviewed 37 patients with pyogenic flexor tenosynovitis who were managed as outpatients. Each patient underwent operative irrigation and debridement with intraoperative catheter irrigation. Postoperatively, patients were treated with outpatient intravenous antibiotics. Conversion to oral antibiotics was based on intraoperative culture results. Using this protocol, the average length of intravenous antibiotic usage was 3.5 days. Of the 28 patients with documented follow-up, 27 resolved the infection and one had a recurrence of the infection. No amputations were noted. Total active motion measurement was obtained from 15 patients showing good or excellent results in 14 of 15 patients. This preliminary retrospective case cohort suggests favorable results with outpatient treatment of pyogenic flexor tenosynovitis.

Ambulatory Care↗
PubMed1991

Septic tenosynovitis in horses: 25 cases (1983-1989).

The medical records of 25 horses with septic tenosynovitis treated over 7 years (1983 to 1989) were reviewed to determine clinical features of the disease and response to treatment. The median age of horses with septic tenosynovitis was 5 years (range, 1 month to 21 years). Fourteen fore limbs and 11 hind limbs were affected. Sepsis was located in the sheath of the digital flexor tendons of 22 horses. Sepsis was located in the sheath of the extensor carpi radialis tendon (1 horse), sheath of the long digital extensor tendon (1 horse), or sheath of the common digital extensor tendon (1 horse) in the remaining horses. Nine horses received only medical treatment, using a combination of broad-spectrum parenterally administered antimicrobial drugs (8 of 9 horses), nonsteroidal anti-inflammatory drugs (8 of 9 horses), or irrigation of the wound (4 of 9 horses). Fourteen horses were treated surgically with either transection of the palmar/plantar annular ligament of the metacarpo/metatarsophalangeal joint (5 of 14 horses), lavage of the sheath after insertion of drains into the sheath (7 of 14 horses), or both (2 of 14 horses). All horses treated surgically were concurrently treated parenterally with broad-spectrum antimicrobial drugs and nonsteroidal anti-inflammatory drugs. Two horses with septic tenosynovitis were not treated and were euthanatized at the owners' request. Five horses were euthanatized before discharge from the hospital. Two horses (both treated medically) were lost to follow-up. Follow-up information was obtained for 18 horses, 6 to 55 months after discharge from the hospital.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1991

[Tendinitis and tenosynovitis of the wrist].

Tendinitis and tenosynovitis of the wrist are often encountered in daily medical practice. This frequency is due to the long course of the tendons over the wrist, to the role played by these tendons in the mobilization and stabilization of that joint and to overuse of the hand in daily life as well as in professional and sporting activities. In their common form tendinitis and tenosynovitis are benign and episodic diseases which may present under two aspects: straightforward tenosynovitis with exsudation, crepitus, stenosis or adhesion, and tendinitis at the sites of attachment. In certain cases the condition is specific and of infectious or inflammatory origin. The diagnosis is based on questioning and on the demonstration, during examination, of a symptomatic triad characterized by resurgence of pain at palpation, inducement of passive tension of the tendon, and resisted muscular contraction. Treatment is based on local injections of corticosteroids and rest. Surgery is seldom indicated.

Humans↗
PubMedDate not supplied

The effect on newborn chicks of oral inoculation of reovirus isolated from chickens with tenosynovitis.

Reovirus strain 176, isolated from chickens with tenosynovitis, was highly pathogenic following oral inoculation of 1-day-old specific-pathogen-free chicks. Disseminated lesions including hepatic necrosis, splenic lymphostromal cell hyperplasia, and bursal atrophy occurred on day 3 postinoculation (PI), followed by myocarditis on day 6 PI and by pericarditis and tenosynovitis on day 9 PI. Reovirus was isolated from the liver as early as day 1 PI, whereas significant neutralizing antibody was detected on day 13 PI. Mortality occurred from day 4 to day 7 PI, and the death of birds was associated with the severity of hepatic necrosis. The occurrence of tenosynovitis in virus-inoculated birds was subclinical.

Animals↗
PubMed1983

Mycoplasma gateae arthritis and tenosynovitis in cats: case report and experimental reproduction of the disease.

Polyarthritis and tenosynovitis were diagnosed in a cat. Clinical signs of 2 months' duration included swollen limbs, painful joints (sensitive to touch), lameness, and pyrexia. Laboratory test data revealed hypogammaglobulinemia, hypoalbuminemia, leukocytosis, and mild anemia. The cat was euthanatized and necropsied; there were chronic necrotizing fibrinopurulent tenosynovitis and arthritis with bone and cartilage erosions. Cultural examinations of synovia were positive for Mycoplasma gateae, but bacterial and viral cultural examinations were negative. Organisms propagated from the M gateae isolate were inoculated IV into 6 specific-pathogen-free cats--3 of these being subjected to immunosuppression induced with azathioprine. The 6 inoculated cats became lame 5 to 9 days later, and 5 became febrile. Cultural examinations of the pharynx in 4 cats were positive for M gateae and in 3 cats, the organism was isolated from various joints. Microscopically, arthritis and tenosynovitis were identified in all cats. Two specific-pathogen-free cats were used as controls (noninoculated); these did not become lame, had negative M gateae cultures, and were free of histopathologic abnormalities. Reproduction of disease with recovery of the causative agent indicates the pathogenicity of this particular isolate of M gateae in the cat when inoculated IV.

Animals↗
PubMedDate not supplied

Infectious tenosynovitis in young turkeys.

Two viruses serologically related to the tenosynovitis virus of chickens were isolated from two flocks of turkeys experiencing outbreaks of tenosynovitis. Both viruses produced a tenosynovitis when injected into the foot pad of young turkeys. Staphylococcus aureus was not isolated from either flock, nor was there any evidence of Mycoplasma synoviae antibody in either flock.

Animals↗
PubMed1994

[New possibilities for the diagnosis of septic tenosynovitis of the digital flexor tendon sheath in cattle using sonography--therapy and long-term results].

Sonographic examination is a new and very effective method in diagnosing of septic tenosynovitis in cattle and may be regarded as an valuable help to the classic diagnostic methods. Among 563 patients, 22 animals suffered exclusively from a serofibrinous, purulent or necrotising tenosynovitis of the digital flexor tendon sheath. In 11 cases, a resection of both flexor tendons, in 2 cases a resection of the deep flexor tendon only were performed, and in 4 cases the tendon sheath was surgically opened and irrigated. 5 animals were slaughtered after diagnosing, because both tendon sheaths of the same limb suffered from a purulent or necrotising tenosynovitis. Surgery was performed using intravenous regional anesthesia and antibiosis. Clinical, radiographic, sonographic and centesis findings are presented. Sonography enabled an accurate assessment of the extent of the inflammation and an assessment of eventual adhesions. It was therefore possible to obtain a comprehensive preoperative image about the condition of the diseased tendon sheath. Intraoperative findings are compared with sonographic diagnosis. After an average hospitalisation of 26.5 days, the patients returned to their owners. Postoperative long term follow-up from 8 months to a maximum of 8 years was evaluated in 17 animals. The minimum duration of economic use of all animals averaged 29.2 months with a range of 1 to 69 months. At the time of survey 9 cows (52.9%) were still alive. 15 cows (88.2%) produced a total of 34 calves with a maximum of 6 calves in one cow. Details on the status of the operated limb, the postoperative milk yield and reasons for culling are discussed.

Animals↗
PubMed1994

Psychomotor capacity and occurrence of wrist tenosynovitis.

A case-referent study was carried out among meatcutters, sausage markers, and packers in a large meat-processing plant to investigate the association between psychomotor capacity and occurrence of tenosynovitis. Reaction time, movement time, manual dexterity, visual attention and visuospatial ability were measured in 26 cases with a history of two or more episodes of tenosynovitis and 26 referents of similar gender, occupation, age, and job seniority with no episodes of the disease. No differences were found between the cases and the referents in any of the tests of psychomotor capacity. The results suggest that psychomotor capacity, as measured with the tests of this study, is a poor predictor of wrist tenosynovitis.

Adult↗
PubMed1996

Rheumatoid flexor tenosynovitis and rupture.

Rheumatoid flexor tenosynovitis at the wrist can cause locking, limitation of motion, nerve compression, and rupture of tendons. To prevent and treat these conditions, a flexor tenosynovectomy, combined with nerve decompression and tendon reconstruction as indicated, is necessary. If tendons are ruptured, the flexor pollicis longus and profundus to the index finger are most commonly affected. On the fingers flexor tenosynovitis can also cause locking, decrease in range of motion and rupture tendons. Flexor tenosynovitis of the fingers should be treated with decompression of the tendons health with preservation of the pulley system.

Carpal Tunnel Syndrome↗
PubMed1998

[Pigmented nodular tenosynovitis. A misdiagnosed etiology of isolated tumefaction of fingers or toes].

BACKGROUND: Pigmented nodular tenosynovitis (more commonly called giant cell tumor) is a benign tumor of synovial joint or tendon sheaths. CASE REPORT: A 17-year-old girl had a tumefaction of the first toe. The mass was firm and painless and had been present for one year. Radiological studies revealed a cystic area of the first phalanx. Magnetic resonance imaging demonstrated a poorly vascularized tissular lesion. Surgical excision of the tumor was performed. Macroscopic and histologic findings confirmed the diagnosis of pigmented nodular tenosynovitis. DISCUSSION: Clinical and radiological aspects of nodular tenosynovitis are characteristic. This diagnosis should be made by dermatologists. Eighty percent of cases occur in fingers and more rarely in toes. Patients are usually females (60 p. 100). A subcutaneous mass is the most common presenting sign whereas pain or joint swelling are rare. Optimal treatment is surgical resection. The only risk is recurrence (20 p. 100).

Adolescent↗
PubMed2005

Gouty flexor tenosynovitis of the hand mimicking atypical mycobacterial infection.

A 50-year-old Japanese fish dealer presented with painful and swollen fingers. Infectious flexor tenosynovitis with Mycobacterium marinum was suspected. Range of motion was restored after tenosynovectomy and after ofloxacin and clarithromycin were administered. Two years after the operation, the patient presented again with acute inflammation in the same fingers. Histopathological examination revealed gouty tenosynovitis. The preconception that mycobacterial infection occurs often in fish dealers caused us to miss the correct diagnosis of gouty tenosynovitis.

Journal Article↗
PubMed2006

The scintigraphic appearance of de Quervain tenosynovitis.

PURPOSE: The purpose of this study is to describe the scintigraphic pattern of de Quervain tenosynovitis, a common inflammatory condition of the thumb tendon sheaths related to repetitive use. MATERIALS AND METHODS: The author conducted a retrospective audit of consecutive cases with independent clinical validation of the final diagnosis. RESULTS: There were 7 cases of clinically confirmed de Quervain tenosynovitis. The typical scintigraphic finding was a focal area of superficial linear hyperemia and skeletal uptake along the radial aspect of the distal radius corresponding to the anatomic location of the abductor pollicis longus and extensor pollicis brevis. All cases showed an abnormality on at least one phase of the bone scan. CONCLUSIONS: Bone scanning appears to be of value in the differential diagnosis of dorsolateral wrist pain when clinical findings are nondiagnostic. The scintigraphic appearance of de Quervain tenosynovitis can help to confirm the diagnosis while excluding other causes of wrist pain. Determining the sensitivity and specificity of this pattern will require further research.

Adult↗
PubMed1977

Hand flexor tenosynovitis in rheumatoid arthritis. Prevalence, distribution, and associated rheumatic features.

Tenosynovitis of one or more flexor tendons of the hand (mean 3.1 tendons per patient) was noted in 55% of 100 patients with rheumatoid arthritis (RA) examined periodically during a mean period of 5 years. The third flexor tendon was involved most frequently (71% of patients), followed by the second (62%), fourth (53%), fifth (27%), and first (13%). Patients with flexor tendonitis (FT) had a significantly higher prevalence of rheumatoid nodules (56% vs 33%), carpal tunnel syndrome (47% vs 13%), wrist extensor tenosynovitis (47% vs 9%), and elbow epicondylitis (22% vs 7%) than patients without FT. Dupuytren's contracture, DeQuervain's tenovaginitis, flexor carpi radialis and ulnaris tendonitis, and Achilles tendonitis were found exclusively in patients with FT. A control group of 50 non-RA patients with FT had statistically fewer diseased tendons per patient (mean 1.5) and a different digital distribution, the thumb being affected more frequently (P less than 0.05) than in RA patients.

Achilles Tendon↗
PubMedDate not supplied

Intratendon sheath corticosteroid treatment of rheumatoid arthritis-associated and idiopathic hand flexor tenosynovitis.

Flexor tenosynovitis (FT) is a common manifestation of rheumatoid arthritis (RA), contributing to hand deformity and manual dysfunction. The efficacy of intratendon sheath corticosteroids was assessed by reviewing the results of such treatment in 173 episodes of FT documented in 46 patients with definite or classic RA. Ninety-three percent of initial episodes resolved completely for 3 or more months (median: 25 months); tenosynovitis did not recur in 59%. The likelihood of a favorable response did not diminish with treatment of recurrent FT in a given digit. Comparable results were found in 52 FT episodes observed in 38 non-RA patients. No tendon sheath or soft tissue infection or tendon rupture ensued in either treatment group. The response was influenced by the specific corticosteroid preparation selected. Based on this experience, a trial of intratendon sheath corticosteroid injections prior to surgical intervention is recommended for RA patients with FT.

Arthritis, Rheumatoid↗
PubMed1991

Treatment of De Quervain's tenosynovitis with corticosteroids. A prospective study of the response to local injection.

Fifty-six cases of De Quervain's tenosynovitis (in 55 patients) were treated with a "long-acting" corticosteroid, methylprednisolone acetate, and followed prospectively over a 4-year period. Approximately 90% of these patients were effectively managed either with a single injection (58%) or with multiple injections (33%) of this compound. Seventeen patients experienced recurrence a mean of 11.9 months after the initial injection. Three had minor flares and were not reinjected; the others responded to reinjections. Ten percent of the cases could not be controlled with local injection, and these patients were referred for surgery. Adverse reactions were self-limited and relatively minor; no tendon ruptures or local infections occurred. We present a discussion of our review of the literature regarding medical therapy and surgical release for this condition. Treatment of De Quervain's tenosynovitis with methylprednisolone acetate injection rapidly controls the signs and symptoms, does not lead to serious adverse reactions, and should be the preferred initial treatment.

Adult↗
PubMed2003

A prolonged case of Mycobacterium marinum flexor tenosynovitis: radiographic and histological correlation, and review of the literature.

We report on a 30-year-old man with prolonged Mycobacterium marinum flexor tenosynovitis. Due to low clinical suspicion, diagnosis was not made until 8 years after initial presentation. The history and magnetic resonance and tissue examination findings are consistent with mycobacterial tenosynovitis. These findings are presented, together with a review of the literature.

Adult↗
PubMed1996

MRI features in de Quervain's tenosynovitis of the wrist.

De Quervain's stenosing tenosynovitis of the first dorsal extensor component is traditionally diagnosed clinically but may be encountered when performing MRI of the wrist. A retrospective review of wrist MR images was performed in cases where the diagnosis of de Quervain's synovitis was suggested (n = 5). Imaging findings were correlated with clinical findings in four cases and with wrist arthroscopy in one case. Increased thickness of the extensor pollicus brevis and abductor pollicis longus tendons was the most reliable finding on MRI, being present in all cases. Peritendinous edema was also a reliable finding. Surrounding subcutaneous edema and increased intratendinous signal were less reliable findings in confirmed cases of de Quervain's disease. De Quervain's tenosynovitis may be encountered when performing MRI of the wrist. Increased tendon thickness and peritendinous edema are the most reliable imaging findings.

Adult↗