scholarly journals Atypical mycobacteriosis presenting as flexor tenosynovitis

2021 ◽  
Author(s):  
Janaína Baggio ◽  
Carla Baleeiro Rodrigues Silva ◽  
Ricardo Cartolano ◽  
Danielle Tiemi Simão ◽  
Andre Silva Franco ◽  
...  
Keyword(s):  
Atypical Mycobacteriosis ◽  
Flexor Tenosynovitis

scholarly journals OP0182 PROTEOGLYCAN LOSS IN ARTICULAR CARTILAGE IS ASSOCIATED WITH JOINT INFLAMMATION SEVERITY IN PSORIATIC ARTHRITIS – A COMPOSITIONAL MAGNETIC RESONANCE IMAGING STUDY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 113.2-113
Author(s):  
P. Sewerin ◽  
D. Abrar ◽  
S. Nebelung ◽  
M. Frenken ◽  
T. Ulrich ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Bone Erosion ◽  
Joint Inflammation ◽  
Resonance Imaging ◽  
Research Support ◽  
Weighted Image ◽  
The Third ◽  
Deutschland Gmbh ◽  
Pip Joint ◽  
Flexor Tenosynovitis

Background:Even though cartilage loss is a known feature of psoriatic arthritis (PsA), little is known about its role in the pathogenesis of PsA. Using delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) as a non-invasive marker of the tissue’s proteoglycan content, such early (i.e. pre-morphological) changes have been associated with inflammation in rheumatoid arthritis (RA). Yet, this association has not been studied before in PsA.Objectives:Is the severity of local joint inflammation associated to local proteoglycan loss in PsA patients?Methods:Metacarpophalangeal (MCP), proximal interphalangeal (PIP), and distal interphalangeal (DIP) joints of 17 patients with active PsA were evaluated by high-resolution clinical standard morphological and dGEMRIC sequences using a 3T MRI scanner (Magnetom Skyra, Siemens) and a dedicated 16-channel hand coil. Images were analyzed by two independent raters for dGEMRIC indices, PsA MRI scores (PsAMRIS) and total cartilage thickness (TCT). Kendall-Tau correlation coefficients (τ) were calculated.Results:We found significant negative correlations between dGEMRIC indices and total PsAMRIS (τ = -0.5, p= 0.012), synovitis (τ = -0.56, p= 0.006), flexor tenosynovitis (τ = -0.4, p= 0.049), and periarticular inflammation (τ = -0.72, p< 0.001). Significant positive correlations were found between TCT and dGEMRIC indices in all joint levels (τ = 0.43, p<0.001). No significant correlations were determined between dGEMRIC indices and bone erosion, bone edema or bone proliferation.Conclusion:In PsA, proteoglycan loss as assessed by dGEMRIC is associated with periarticular inflammation, synovitis, and flexor tenosynovitis, but not with bone erosion or proliferation, thereby highlighting the need for effective anti-inflammatory treatment regimes. Beyond morphology, advanced MRI techniques may be used to assess cartilage composition in PsA and to identify early changes in cartilage as an imaging biomarker with potential application in detection and monitoring of PsA.Figure 1Right hand of a 26-year-old male with psoriatic arthritis Coronal STIR image (A) of digits 1-5, transversal fat-saturated (fs) T2-weighted image of digits 2-4 (B) and the corresponding transversal fs contrast-enhanced T1-weighted image (C) at the distal portion of the proximal phalanges. Horizontal white bar in (A) indicates level of transversal slices (B) & (C). Sagittal fs Proton Density-weighted image of the third digit (D). A: Increased signal at the collateral ligaments and synovitis of the proximal interphalangeal (PIP) joint of the third digit (white arrow). Periarticular inflammation around the PIP joint and the body of the proximal phalanx of the third digit (arrowhead). B & C: Extensive flexor tenosynovitis (asterix) and periarticular inflammation in the subcutaneous tissues (arrowhead) alongside thickened flexor tendon pulleys (arrow). D & E: Representative sagittal T1-weighted images of the MCP, PIP and DIP joint of the 3rd digit. Following iv contrast administration and appropriate delay of 40 min, A gives the morphological T1 map, while B gives the corresponding parameter map with dGEMRIC values [ms] overlaid. Note the significant decrease in dGEMRIC indices of the PIP joint as compared to the MCP joint.Disclosure of Interests:Philipp Sewerin Grant/research support from: AbbVie Deutschland GmbH & Co. KGBristol-Myers Squibb Celgene GmbHLilly Deutschland GmbHNovartis Pharma GmbH Pfizer Deutschland GmbHRheumazentrum Rhein-Ruhr, Consultant of: AMGEN GmbH AbbVie Deutschland GmbH & Co. KG Biogen GmbHBristol-Myers Squibb Celgene GmbH Chugai Pharma arketing Ltd. / Chugai Europe GmbHHexal Pharma Janssen-CilagGmbH Johnson & Johnson Deutschland GmbHLilly Deutschland GmbH / Lilly Europe / Lilly Global Novartis Pharma GmbH Pfizer Deutschland GmbH Roche Pharma Rheumazentrum Rhein-Ruhr Sanofi-Genzyme Deutschland GmbH Swedish Orphan Biovitrum GmbH UCB Pharma GmbH, Speakers bureau: AMGEN GmbH AbbVie Deutschland GmbH & Co. KG Biogen GmbHBristol-Myers Squibb Celgene GmbH Chugai Pharma arketing Ltd. / Chugai Europe GmbHHexal Pharma Janssen-CilagGmbH Johnson & Johnson Deutschland GmbHLilly Deutschland GmbH / Lilly Europe / Lilly Global Novartis Pharma GmbH Pfizer Deutschland GmbH Roche Pharma Rheumazentrum Rhein-Ruhr Sanofi-Genzyme Deutschland GmbH Swedish Orphan Biovitrum GmbH UCB Pharma GmbH, Daniel Abrar: None declared, Sven Nebelung: None declared, Miriam Frenken: None declared, Tim Ulrich: None declared, Karl Ludger Radke: None declared, Gerald Antoch: None declared, Stefan Vordenbäumen: None declared, Ralph Brinks: None declared, Matthias Schneider Grant/research support from: GSK, UCB, Abbvie, Consultant of: Abbvie, Alexion, Astra Zeneca, BMS, Boehringer Ingelheim, Gilead, Lilly, Sanofi, UCB, Speakers bureau: Abbvie, Astra Zeneca, BMS, Chugai, GSK, Lilly, Pfizer, Sanofi, Benedikt Ostendorf: None declared, Christoph Schleich: None declared

PYOGENIC FLEXOR TENOSYNOVITIS

Hand Clinics ◽  
1998 ◽  
Vol 14 (4) ◽  
pp. 567-578
Author(s):  
S. David Boles ◽  
Christopher C. Schmidt
Keyword(s):  
Pyogenic Flexor Tenosynovitis ◽  
Flexor Tenosynovitis

scholarly journals Development of a Murine Model of Pyogenic Flexor Tenosynovitis

2020 ◽  
Author(s):  
Bowen Qiu ◽  
Justin Cobb ◽  
Alayna Loiselle ◽  
Constantinos Ketonis
Keyword(s):  
Murine Model ◽  
Tendon Sheath ◽  
Cellular Infiltrate ◽  
Cellular Mechanisms ◽  
Multiple Comparison Test ◽  
Hematoxylin Staining ◽  
Flexor Tendon Sheath ◽  
Pyogenic Flexor Tenosynovitis ◽  
Novel Therapeutic Strategies ◽  
Flexor Tenosynovitis

ABSTRACTBackgroundTo demonstrate the plausibility of a murine model of pyogenic flexor tenosynovitis.Methods2μL of sterile PBS or bioluminescent Xen29 Staphylococcus aureus was administered to the tendon sheath of 36 male C57BL/6J mice. The infectious course was monitored by bioluminescence (BLI) signal via IVIS imaging and recording of weight change. The infected hind paws were harvested at four time points: 24 hours, 72 hours, 1 week and 2 weeks for histopathology using Alcian Blue hematoxylin staining. Two-way ANOVA with Sidak’s multiple comparison test was used for statistical analysis.ResultsThe infected cohort displayed significantly elevated bioluminescent values, reductions in weight, and exhibited swelling of the infected digit throughout the course of infection. By day 7 most infected mice saw a substantial decrease in BLI signal intensity, however two infected mice exhibited persistent BLI intensity through day 14. Histopathology of the infected cohort showed tissue disorganization and the presence of a cellular infiltrate in and around the flexor tendon sheath.ConclusionsA murine model of pyogenic flexor tenosynovitis is possible. Further optimization of the model offers an experimental platform for investigation of the pathophysiology of pyogenic flexor tenosynovitis.Clinical RelevanceThis animal model can be utilized in order to elucidate the basic molecular/cellular mechanisms of pyogenic flexor tenosynovitis while simultaneously evaluating novel therapeutic strategies.

The Presence of Limited Joint Mobility Is Significantly Associated with Multiple Digit Involvement by Stenosing Flexor Tenosynovitis in Diabetics

2009 ◽  
Vol 36 (8) ◽  
pp. 1686-1690 ◽  
Author(s):  
MAKOTO KAMEYAMA ◽  
SHU MEGURO ◽  
OSAMU FUNAE ◽  
YOSHIHITO ATSUMI ◽  
HIROYASU IKEGAMI
Keyword(s):  
Regression Analysis ◽  
Multiple Regression Analysis ◽  
Multiple Regression ◽  
Diabetic Patients ◽  
Joint Mobility ◽  
Limited Joint Mobility ◽  
Chi Squared ◽  
Tunnel Syndrome ◽  
The Difference ◽  
Flexor Tenosynovitis

Objective.Diabetes is associated with several disorders of the hand, including stenosing flexor tenosynovitis (SFTS). The feature of SFTS in diabetics is a higher prevalence of multiple digit involvement. We examined the magnitude of the tendency for involvement of more digits by SFTS in diabetic patients than in nondiabetic patients, and attempted to clarify the factors influencing multiple digit involvement by SFTS in diabetics.Methods.The study comprised 302 diabetic patients with SFTS and 235 nondiabetic patients with SFTS. The total number of digits exhibiting SFTS within the 1-year period following the initial visit to the Department of Orthopaedic Surgery was investigated in a prospective manner. We compared the difference in the frequency of multiple digit involvement by SFTS between diabetic and nondiabetic patients using the chi-squared test. Multiple regression analysis was performed to examine the contribution of independent variables [defined as 12 factors including age, sex, type of diabetes, estimated duration of diabetes, HbA1c values, carpal tunnel syndrome, Dupuytren contracture, limited joint mobility (LJM), de Quervain's disease, diabetic retinopathy, diabetic nephropathy, and dyslipidemia] to the total number of digits affected by SFTS in diabetic patients.Results.Diabetic patients showed a significantly higher prevalence of multiple digit involvement than nondiabetic patients (p < 0.0001). Multiple regression analysis in diabetic patients revealed that the presence of LJM was positively associated with the prevalence of multiple digit involvement (r = 0.626, p < 0.0001).Conclusion.LJM in diabetics is closely associated with SFTS involving multiple digits.

Continuous Postoperative Catheter Irrigation is not Necessary for the Treatment of Suppurative Flexor Tenosynovitis

2000 ◽  
Vol 25 (3) ◽  
pp. 304-307 ◽  
Author(s):  
S. LILLE ◽  
T. HAYAKAWA ◽  
M. W. NEUMEISTER ◽  
R. E. BROWN ◽  
E. G. ZOOK ◽  
...  
Keyword(s):  
Functional Outcomes ◽  
Pyogenic Flexor Tenosynovitis ◽  
Flexor Tenosynovitis ◽  
Catheter Irrigation

The records of 75 patients admitted with pyogenic flexor tenosynovitis at two academic centers were reviewed. The functional outcomes of patients who received intraoperative irrigation only ( n=20) and those that had both intraoperative irrigation and continuous postoperative irrigation ( n=55) were compared. There were no statistically significant differences between the outcomes in the two groups.

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