scholarly journals Magnetic resonance imaging of diffusion characteristics following collagenase clostridium histolyticum injection in Dupuytren’s contracture

2021 ◽  
Vol 29 (3) ◽  
pp. 230949902110472
Author(s):  
Hiroko Iwakawa ◽  
Shigeharu Uchiyama ◽  
Yasunari Fujinaga ◽  
Masanori Hayashi ◽  
Masatoshi Komatsu ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Flexor Tendon ◽  
Tendon Sheath ◽  
Dupuytren’S Contracture ◽  
Collagenase Clostridium Histolyticum ◽  
Resonance Imaging ◽  
Dupuytren's Contracture ◽  
Clostridium Histolyticum ◽  
Signal Change

Purpose We aimed to evaluate the extent of collagenase clostridium histolyticum (CCH) diffusion in Dupuytren’s contracture (DC) for tissues outside of the contracture cord using Magnetic Resonance Imaging (MRI) immediately after CCH injection. Methods: 10 male patients aged 57–79 with DC of the metacarpophalangeal (MCP) joints were examined. Extension deficits were 10–60°(mean, 34.3) and 0–60°(mean, 26.6) in the MCP and proximal interphalangeal (PIP) joints, respectively. CCH injection was performed according to the standard method. MRI was performed within 15 min of CCH injection. Results: In all 10 cases, the extended area of high-intensity signal change outside of the cord was observed on short-T1 inversion recovery images (STIRs). Continuity from the insertion site was observed in the area of signal change involving the flexor tendon and neurovascular bundle. The signal change area spanned distally and proximally beyond the injection level. The signal change area expanded along the tendon sheath but no signal changes were observed inside the flexor tendon, suggesting the tendon sheath serves as a protective barrier from the CCH solution. After 1 week of injection, the mean decrease in contracture was 32.5°(94.7%) for the MCP joint and 19.8°(74.4%) for the PIP joint. In nine out of 10 cases, the extension deficit was within five degrees of full extension in the affected finger. There was no neurovascular injury or tendon rupture at 3 months of observation. Conclusions: MRI indicated the possible leakage of the drug outside of the cord during the early phase after administration, suggesting that CCH could persistently affect healthy tissues until CCH inactivates its enzyme process.

scholarly journals Comparison Between Ultrasonographic and Standing Magnetic Resonance Imaging Findings in the Podotrochlear Apparatus of Horses With Foot Pain

2021 ◽  
Vol 8 ◽  
Author(s):  
Laurence Evrard ◽  
Zoë Joostens ◽  
Maxime Vandersmissen ◽  
Fabrice Audigié ◽  
Valeria Busoni
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Flexor Tendon ◽  
Compact Bone ◽  
Navicular Bone ◽  
Foot Pain ◽  
Imaging Findings ◽  
Resonance Imaging ◽  
Radiographic Diagnosis ◽  
Signal Change

This prospective study aimed to blindly compare the ultrasonographic and standing magnetic resonance imaging (sMRI) findings in deep digital flexor tendon (DDFT), navicular bone, and navicular bursa in horses with foot pain, positive digital analgesia, and without definitive radiographic diagnosis. Ultrasonography detected more DDFT abnormalities (32/34 feet vs. 27/34 with sMRI) but identified less palmar navicular abnormalities (23/34 feet vs. 30/34 with sMRI). In suprasesamoidean DDFT lesions, which were mainly dorsally located, changes in echogenicity did not correspond to a particular pattern of sMRI signal change. Transcuneal ultrasonography did not allow assessment of morphology and extent of distal DDFT lesions, and sporadically discriminated the affected lobe compared to sMRI. Defects of the palmar compact bone were identified with both modalities except a parasagittal defect, which was only seen at sMRI.

Efficacy and safety of collagenase Clostridium histolyticum injection for Dupuytren’s contracture in non-Caucasian Japanese patients (CORD-J Study): the first clinical trial in a non-Caucasian population

2016 ◽  
Vol 42 (1) ◽  
pp. 30-38 ◽  
Author(s):  
H. Hirata ◽  
K. Tanaka ◽  
A. Sakai ◽  
R. Kakinoki ◽  
H. Ikegami ◽  
...  
Keyword(s):  
Clinical Success ◽  
Japanese Patients ◽  
Phase Iii ◽  
Dupuytren’S Contracture ◽  
Collagenase Clostridium Histolyticum ◽  
Open Label ◽  
Level Of Evidence ◽  
Dupuytren's Contracture ◽  
Clostridium Histolyticum ◽  
Corrective Effect

To assess the efficacy, safety and pharmacokinetics of 0.58 mg collagenase Clostridium histolyticum injections for the treatment of Dupuytren’s contracture in Japanese patients, we conducted a phase III, multicentre, uncontrolled, open-label clinical study in patients with Dupuytren’s contracture. Of the 77 patients, 66 achieved clinical success in the primary treated joint (86%; 95% confidence interval: 76% to 93%), confirming the efficacy of collagenase Clostridium histolyticum injections. More improvement was seen in the metacarpophalangeal joints than in the proximal interphalangeal joints (94% versus 73%). The main adverse reaction was a local reaction in the injected hand. No tendon rupture or anaphylactic reactions were seen. The concentrations of collagenase Clostridium histolyticum were below the lower limit of quantification in plasma samples at all time points. As seen in global studies in Caucasian patients, a corrective effect on Dupuytren’s contracture and good tolerance were observed in most non-Caucasian (Asian) Japanese patients. Level of Evidence: Level 3

Comparison of Magnetic Resonance Imaging and Ultrasound Evaluations of Zone II Partial Flexor Tendon Lacerations

2020 ◽  
Author(s):  
Andrew R. Stephens ◽  
Kristin L. Buterbaugh ◽  
Joshua A. Gordon ◽  
David R. Steinberg ◽  
David J. Bozentka ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Flexor Tendon ◽  
Resonance Imaging ◽  
Zone Ii
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