Epithelial inclusion cyst of the equine digital flexor tendon sheath: diagnosis by ultrasonography and magnetic resonance and successful treatment by tenoscopy

2019 ◽  
Vol 88 (6) ◽  
pp. 320-326 ◽  
Author(s):  
Z. Joostens ◽  
L. Vanslambrouck ◽  
H. De Cock ◽  
T. Mariën
Keyword(s):  
Magnetic Resonance ◽  
Flexor Tendon ◽  
Surgical Excision ◽  
Tendon Sheath ◽  
Good Prognosis ◽  
Inclusion Cyst ◽  
Flexor Tendon Sheath ◽  
Dense Mass ◽  
Epithelial Inclusion Cyst ◽  
Distal Aspect

A six-year-old warmblood horse was presented with a longstanding frontlimb lameness with mild digital flexor tenosynovitis and swelling of the distomedial pastern. Ultrasonography and magnetic resonance revealed a dense mass lesion in the distal aspect of the digital flexor tendon sheath, with a partial lamellar architecture, absence of internal vascularization and adjacent smooth pressure osteolysis of the middle phalanx. After surgical excision, histopathology confirmed an epithelial inclusion cyst. Epithelial inclusion cysts, also known as keratinizing or follicular cysts, are expansile benign mass-like lesions of aberrant epidermal tissue. In the horse, they are known to occur in cutaneous and several non-cutaneous tissues. In the digital flexor tendon sheath, they have rarely been described. Given their often chronic presentation in this location, they may appear as an atypical dense mass on imaging, uncommon for cystic lesions. Complete tenoscopic removal, even for larger masses, is achievable and considered curative with good prognosis for return.

scholarly journals Flexor Tendon Sheath Ganglions: Results of Surgical Excision

Hand ◽  
2007 ◽  
Vol 2 (3) ◽  
pp. 94-100 ◽  
Author(s):  
Peter J. L. Jebson ◽  
Edwin E. Spencer
Keyword(s):  
Telephone Interview ◽  
Flexor Tendon ◽  
Surgical Excision ◽  
Tendon Sheath ◽  
Additional Patient ◽  
Dominant Hand ◽  
Digital Nerve ◽  
A2 Pulley ◽  
Flexor Tendon Sheath

The purpose of our study was to review the clinical features and determine the results following surgical excision of a flexor tendon sheath ganglion. A retrospective analysis of 24 consecutive patients (25 ganglions) who underwent excision of a painful flexor tendon sheath ganglion by the same surgeon was performed. The patient's medical and operative records were reviewed. Each patient was invited to return for an evaluation, which consisted of a clinical interview, completion of a questionnaire, and physical examination. Those patients that were unable to return underwent a detailed telephone interview. Sixteen patients returned for a clinical evaluation, while eight patients underwent a telephone interview. There were 15 women and nine men, with an average age of 43 years (range, 21–68 years). The dominant hand was involved in 15 patients. The long finger was most commonly involved (11 cases). The ganglion arose from the A1 pulley in 13 cases, between the A1 and A2 pulleys in three cases, and from the A2 pulley in nine cases. At an average follow-up of 18.5 months (range, 5–38 months), all of the patients were satisfied with their final result. No patient developed a recurrence and all returned to their previous functional level. There were two minor complications that resolved uneventfully; one patient experienced mild incisional tenderness, while an additional patient experienced transient digital nerve paresthesias. We conclude that surgical excision is a simple, safe, and effective method for treating a painful ganglion of the digital flexor tendon sheath.

scholarly journals Joint mice migration into the deep digital flexor tendon sheath in dogs

2008 ◽  
Vol 21 (05) ◽  
pp. 440-445 ◽  
Author(s):  
T. Guerrero ◽  
S. Ohlerth ◽  
M. Hässig ◽  
K. Voss ◽  
P. M. Montavon ◽  
...  
Keyword(s):  
Contrast Media ◽  
Flexor Tendon ◽  
Surgical Excision ◽  
Tendon Sheath ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Clinical Progression ◽  
Flexor Muscle ◽  
Talocrural Joint ◽  
Flexor Tendon Sheath

SummaryThis study describes the appearance of ‘joint mice’ in the sheath of the deep digital flexor muscle tendon (DDFT) due to osteochondritis dissecans (OCD) lesions in the talocrural joint of 12 dogs. Surgical excision of all free fragments in the DDFT sheath was performed in five dogs, and their clinical progression was documented. The excision of free fragments from the DDFT sheath, but not arthro-tomy, proved clinically beneficial despite the presence of degenerative joint disease. The anatomical communication between the talocrural joint and the DDFT sheath and its dimensions are further illustrated with the use of contrast media and dissection of cadaver limbs.

scholarly journals Extra-articular tenosynovial chondromatosis of the right fifth digit in a 59-year-old man: A case report and literature review.

2021 ◽  
Vol 15 (8) ◽  
pp. 8-17
Author(s):  
Sunny Qi-Huang ◽  
Fred Alejandro Loor Jacho ◽  
David Lisa ◽  
Ephram Weingarten
Keyword(s):  
Clinical Presentation ◽  
Flexor Tendon ◽  
Surgical Excision ◽  
Tendon Sheath ◽  
Plain Radiography ◽  
History Of ◽  
Flexor Tendon Sheath ◽  
The Right ◽  
Hands And Feet ◽  
Tenosynovial Chondromatosis

Tenosynovial chondromatosis is a rare benign disorder characterized by formation of cartilaginous bodies within the synovia of the tendon sheaths. Most commonly present in the hands and feet. Clinical presentation and plain radiography can be inconclusive, which can lead to misclassification, most often confused as a chondroma of soft parts. In this case, we report the clinical, radiologic, and histology of a 59-year-old man who presented with a 1-year history of mass on the right fifth digit with limitation of motion secondary to this condition. Surgical excision revealed multiple cartilaginous nodules of varying size arising from the flexor tendon sheath. The diagnosis was confirmed postoperatively by surgical histopathology. The postoperative course of the patient was uncomplicated and has achieved an excellent functional recovery.

FLEXOR TENDON SHEATH GANGLION: ANALYSIS OF 128 CASES

Hand Surgery ◽  
2004 ◽  
Vol 09 (01) ◽  
pp. 1-4 ◽  
Author(s):  
Y. Abe ◽  
H. K. Watson ◽  
S. Renaud
Keyword(s):  
Sex Ratio ◽  
Flexor Tendon ◽  
Surgical Excision ◽  
Middle Finger ◽  
Tendon Sheath ◽  
Hand Dominance ◽  
Percutaneous Puncture ◽  
Previous Trauma ◽  
A2 Pulley ◽  
Flexor Tendon Sheath

A 30-year analysis of 128 patients with flexor tendon sheath ganglion was investigated. The majority of patients were females with sex ratio of 2.6 : 1. Most of the patients are in their third to fifth decade of life. Hand dominance, previous trauma as well as other illnesses involving the hand did not show any correlation to the formation of ganglion. The middle finger was most commonly affected and 69% of the ganglion were located on A1 and A2 pulley. Recurrence was high (89%) after multiple percutaneous puncture and treatment was successful with no cases of recurrence after surgical excision.

Transthecal Digital Nerve Block

1998 ◽  
Vol 23 (4) ◽  
pp. 490-493 ◽  
Author(s):  
N. S. SARHADI ◽  
J. SHAW-DUNN
Keyword(s):  
Methylene Blue ◽  
Nerve Block ◽  
Flexor Tendon ◽  
Proximal Phalanx ◽  
Proximal Part ◽  
Tendon Sheath ◽  
Areolar Tissue ◽  
Digital Nerve ◽  
Flexor Tendon Sheath ◽  
Digital Nerve Block

Injection studies using methylene blue and latex were used in 60 digits from 40 cadavers to study how anaesthetic fluid injected into the flexor tendon sheath might spread around the proximal part of the finger. The injected solution escaped from the flexor tendon sheath around the vincular vessels which are present near the base and head of the proximal phalanx. Outside the digital canal, the dye flowed smoothly through the perivascular loose areolar tissue and spread alongside the main digital vessels and nerves and their palmar and dorsal branches.

The Sesamoids of the Metacarpo-Phalangeal Joint of the Thumb: An Anatomical and Clinical Study

1989 ◽  
Vol 14 (2) ◽  
pp. 244-247
Author(s):  
J. D. GIBEAULT ◽  
P. SABA ◽  
H. HOENECKE ◽  
A. GRAHAM
Keyword(s):  
Clinical Study ◽  
Flexor Tendon ◽  
Tendon Sheath ◽  
Volar Plate ◽  
Histological Studies ◽  
Anatomical Dissection ◽  
Flexor Tendon Sheath

Two unusual cases of injury to the sesamoids of the M.P. joint of the thumb are described. An anatomical dissection of the M.P. volar plate region, including the sesamoids, was undertaken to delineate the details of the sesamoids’ relationship to the M.P. joint, flexor tendon, flexor tendon sheath and capsule of the joint. Histological studies were carried out to demonstrate a tendinous extension of the muscles that attach to the sesamoids.

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