scholarly journals Digital flexion contracture caused by tophaceous gout in flexor tendon

2019 ◽  
Vol 7 ◽  
pp. 2050313X1984470 ◽  
Author(s):  
Tsuyoshi Tajika ◽  
Takuro Kuboi ◽  
Tokue Mieda ◽  
Noboru Oya ◽  
Fumitaka Endo ◽  
...  
Keyword(s):  
Flexor Tendon ◽  
Full Range ◽  
Rare Condition ◽  
Metacarpophalangeal Joint ◽  
Flexion Contracture ◽  
Proper Treatment ◽  
Histological Findings ◽  
Tophaceous Gout ◽  
Gouty Tophus ◽  
White Substance

Gouty tophus is an unusual cause of digital flexion contracture. Awareness of this pathophysiology will lead to more confidence in proper treatment and surgical management of this rare condition. This report describes a case of digital flexion contracture by tophaceous gout distinguished between trigger finger and locking of the metacarpophalangeal joint. We found the flexor tendon with a deposited chalky white substance suggestive of gouty tophus intraoperatively. We performed tenosynovectomy and removed the chalky white substance to the greatest degree possible. Histological findings confirmed the diagnosis of gout. Postoperatively, the patient recovered nearly to a full range of motion of the affected digits. When meeting with the patient who has had hyperuricemia and who is unable to extend the affected digits suddenly, one must keep in mind digital flexion contracture caused by tophaceous gout.

Trigger Wrist Caused by a Giant Cell Tumour of Tendon Sheath

1985 ◽  
Vol 10 (1) ◽  
pp. 121-123 ◽  
Author(s):  
N. SUEMATSU ◽  
T. HIRAYAMA ◽  
Y. TAKEMITSU
Keyword(s):  
Giant Cell ◽  
Medical Literature ◽  
Giant Cell Tumour ◽  
Flexor Tendon ◽  
Rare Condition ◽  
Tendon Sheath ◽  
Metacarpophalangeal Joint ◽  
Cell Tumour ◽  
Flexor Tendon Sheath ◽  
Trigger Wrist

Trigger wrist is a rare condition unlike the trigger finger of the metacarpophalangeal joint. This report describes a case of trigger wrist secondary to a giant cell tumour of the flexor tendon sheath. No previous reports are available in the medical literature.

scholarly journals Gouty flexor tenosynovitis – Case report and review of the literature

2021 ◽  
Vol 2 (3) ◽  
Author(s):  
Hannes Prescher ◽  
◽  
Chad M Teven ◽  
Deana Shenaq ◽  
Patrick L Reavey ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Flexor Tendon ◽  
Flexion Contracture ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Rare Presentation ◽  
Gouty Tophus ◽  
High Level ◽  
Flexor Tenosynovitis ◽  
Urate Crystals

Gout is a rare cause of tenosynovitis and is difficult to diagnose based on clinical symptoms and imaging modalities. We present a case of gouty tenosynovitis of the proximal interphalangeal joint. A 32-year old male patient presented with a swollen, painful proximal interphalangeal joint of the 3rd digit on his right hand for 2 weeks with flexion contracture. Surgical exploration of the affected joint revealed a gouty tophus with extensive infiltration of the underlying flexor tendon. A tenosynovectomy and flexor tendon release was performed to treat the flexion contracture. Pathology disclosed urate crystals deposited within the tendon. Gouty infiltration of the flexor tendons of the hand can lead to extensive damage and compromised function. A high level of clinical suspicion is required as gouty tenosynovitis is a rare presentation and can often mimic an infectious etiology. Keywords: Gout; Tenosynovitis; Flexor tendon; Hand; Tophi.

A Case of Destructive Gout in the Hand

1993 ◽  
Vol 1 (2) ◽  
pp. 91-94
Author(s):  
Robert Backstein ◽  
Arnis Freiberg ◽  
Tim Haswell
Keyword(s):  
Flexor Tendon ◽  
Gouty Arthritis ◽  
Tendon Sheath ◽  
Metacarpophalangeal Joint ◽  
Flexor Digitorum Profundus ◽  
Prior History ◽  
Tophaceous Gout ◽  
Radiologic Findings ◽  
Microscopic Evaluation ◽  
One Year

R Backstein, a Freiberg, T Haswell. A case of destructive gout in the hand. Can J Plast Surg 1993;1(2):91-94. A 49-year-old male presented with bilateral finger masses of one year duration. Radiologic findings were consistent with chronic tophaceous gout and this diagnosis was confirmed by microscopic evaluation of pathologic specimens. The patient had no prior history of acute gouty arthritis. Surgical exploration revealed tophaceous masses involving the metacarpophalangeal joint and the contents of the flexor tendon sheath of the left long finger with complete destruction of the flexor digitorum profundus tendon distal to the sublimus insertion. Gout presenting as tophaceous deposits of the finger with flexor tendon destruction has not previously been described in the literature.

Incidence of tenolysis and features of adhesions in the digital flexor tendons after multi-strand repair and early active motion

2018 ◽  
Vol 44 (4) ◽  
pp. 354-360 ◽  
Author(s):  
Koji Moriya ◽  
Takea Yoshizu ◽  
Naoto Tsubokawa ◽  
Hiroko Narisawa ◽  
Yutaka Maki
Keyword(s):  
Flexor Tendon ◽  
Full Range ◽  
Tendon Repair ◽  
The Other ◽  
Flexor Digitorum Superficialis ◽  
Flexor Tendon Repair ◽  
Level Of Evidence ◽  
Active Motion ◽  
Active Mobilization ◽  
Flexor Digitorum

We report seven patients requiring tenolysis after primary or delayed primary flexor tendon repair and early active mobilization out of 148 fingers of 132 consecutive patients with Zone 1 or 2 injuries from 1993 to 2017. Three fingers had Zone 2A, two Zone 2B, and two Zone 2C injuries. Two fingers underwent tenolysis at Week 4 or 6 after repair because of suspected repair rupture. The other five fingers had tenolysis 12 weeks after repair. Adhesions were moderately dense between the flexor digitorum superficialis and profundus tendons or with the pulleys. According to the Strickland and Tang criteria, the outcomes were excellent in one finger, good in four, fair in one, and poor in one. Fingers requiring tenolysis after early active motion were 5% of the 148 fingers so treated. Indications for tenolysis were to achieve a full range of active motion in the patients rated good or improvement of range of active motion of the patients rated poor or fair. Not all of our patients with poor or fair outcomes wanted to have tenolysis. Level of evidence: IV

Cleland’s ligaments and Dupuytren’s disease

2013 ◽  
Vol 39 (5) ◽  
pp. 477-481 ◽  
Author(s):  
D. J. Shewring ◽  
U. Rethnam
Keyword(s):  
Histological Analysis ◽  
Residual Disease ◽  
Flexion Contracture ◽  
Joint Contracture ◽  
Dupuytren’S Disease ◽  
Histological Findings ◽  
Dupuytren's Disease ◽  
Pip Joint ◽  
Joint Flexion ◽  
Neurovascular Bundles

The aim of this study was to investigate whether Cleland’s ligaments are affected by Dupuytren’s disease and assess their contribution to the flexion contracture of the proximal interphalangeal (PIP) joint. Twenty patients with Dupuytren’s disease undergoing fasciectomy for a PIP joint contracture > 40° (mean 61°, range 45°–100°) were included. After excision of all other identifiable digital disease, Cleland’s ligaments were assessed. If they appeared to be macroscopically affected by Dupuytren’s disease they were excised, sent for histological analysis, and any further improvement of PIP joint contracture was recorded. There were 14 males and six females with a mean age of 62 (range 40–79) years. Excision of Cleland’s ligaments resulted in a mean further correction of 7° (range 0°–15°). Histological analysis indicated that Cleland’s ligament was clearly involved with Dupuytren’s disease in 12 patients, indicating that Cleland’s ligaments can be affected by Dupuytren’s disease. In the remaining specimens the histological findings were equivocal. As these structures are situated dorsal to the neurovascular bundles, a specific dissection has to be undertaken to identify them. Excision of Cleland’s ligaments at digital fasciectomy further avoids leaving residual disease and may yield a worthwhile further correction of PIP joint flexion contracture.

Palmar Dislocation of the Metacarpophalangeal Joint of the Finger

2004 ◽  
Vol 29 (1) ◽  
pp. 90-93 ◽  
Author(s):  
TSUYOSHI MURASE ◽  
HISAO MORITOMO ◽  
HIDEKI YOSHIKAWA
Keyword(s):  
Open Reduction ◽  
Flexor Tendon ◽  
Tendon Sheath ◽  
Metacarpophalangeal Joint ◽  
Collateral Ligaments ◽  
Flexor Tendon Sheath ◽  
Joint Disruption ◽  
Supporting Structures

We report a case of palmar dislocation of a finger metacarpophalangeal joint. Disruption of all the supporting structures of this joint and rupture of the flexor tendon sheath caused marked instability. Treatment was by open reduction and repair of the collateral ligaments.

Closed Reduction and Percutaneous Pinning of Fractures of the Proximal Phalanx

2001 ◽  
Vol 26 (1) ◽  
pp. 45-49 ◽  
Author(s):  
E. E. HORNBACH ◽  
M. S. COHEN
Keyword(s):  
Flexor Tendon ◽  
Proximal Phalanx ◽  
Flexion Contracture ◽  
Proximal Interphalangeal Joint ◽  
Joint Motion ◽  
Percutaneous Pinning ◽  
Kirschner Wires ◽  
Rotational Deformity ◽  
Active Motion ◽  
Total Active Motion

This study reports the results of 12 unstable extraarticular fractures of the proximal phalanx treated with transarticular intramedullary Kirschner wires. Early proximal interphalangeal joint motion was allowed and all patients achieved uneventful union, with an average total active motion of 265°. Objective physical assessment revealed one significant flexion contracture, one flexor tendon adhesion and one significant rotational deformity. Excellent results were observed in ten of the 12 patients.

A comparative analysis of the outcome of flexor tendon repair in the index and little fingers: does the little finger fare worse?

2011 ◽  
Vol 37 (1) ◽  
pp. 20-26 ◽  
Author(s):  
K. S. Orkar ◽  
C. Watts ◽  
F. C. Iwuagwu
Keyword(s):  
Flexor Tendon ◽  
Index Finger ◽  
Tendon Repair ◽  
Flexion Contracture ◽  
Hand Therapy ◽  
Flexor Tendon Repair ◽  
Single Digit ◽  
Significant Difference ◽  
Little Finger

The clinical and hand therapy notes of 180 patients who had single digit flexor tendon repairs in zones I and II from January 2000 to December 2004 were reviewed. Data from 60 index and 108 little fingers at 5 weeks, 8 weeks and 12 weeks follow-up visits were included. In zone I injuries, there was a statistically significant difference in flexion contracture (worse in the little fingers ) at all follow-up points. Although the range of motion and percentage of patients in the excellent category of the Strickland and Glogovac criteria were greater in the index finger group than the little finger for zone I and II injuries, these differences were not statistically significant. The rupture rate was also higher in the little finger group.

scholarly journals Tophaceous gout in thoracic spine mimicking meningioma: A case report and literature review

2020 ◽  
Vol 11 ◽  
pp. 364
Author(s):  
Ratish Mishra ◽  
Vishnu Prasad Panigrahi ◽  
Nitin Adsul ◽  
Sunila Jain ◽  
R. S. Chahal ◽  
...  
Keyword(s):  
Back Pain ◽  
Cord Compression ◽  
Appendicular Skeleton ◽  
Tophaceous Gout ◽  
Decompressive Laminectomy ◽  
Dural Sac ◽  
Thoracic Spinal ◽  
Spinal Lesion ◽  
Intradural Extramedullary ◽  
Gouty Tophus

Background: Gout is a common metabolic disorder of purine metabolism, causing arthritis in the distal joints of the appendicular skeleton. Spine involvement is rare, and very few cases of spinal gout have been reported. The authors present a rare case of axial gout with tophaceous deposits in the thoracic spinal canal resulting in cord compression and mimicking a meningioma. Case Description: A 33-year-old male presented with chronic mid back pain and a progressive paraparesis. The presumed diagnosis was meningioma based on MR imaging with/without contrast that showed a posterolateral, right-sided, and T10-T11 intradural extramedullary lesion. Notable, was hyperuricemia found on hematological studies. The patient underwent a decompressive laminectomy (T9-T11) for excision of the lesion, intraoperatively, an intraspinal, chalky, white mass firmly adherent to and compressing the dural sac was removed. The histopathology confirmed the diagnosis of a gouty tophus. Postoperatively, the patient’s pain resolved, and he regained the ability to walk. Conclusion: A gouty tophus should be included among the differential diagnostic considerations when patients with known hyperuricemia present with back pain, and paraparesis attributed to an MR documented compressive spinal lesion.

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