Instability of the PIP joint D3

2021 ◽  
Author(s):  
Dirk Herter
Keyword(s):  
Pip Joint

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

scholarly journals Two-component surface replacement implants compared with perichondrium transplantation for restoration of Metacarpophalangeal and proximal Interphalangeal joints: a retrospective cohort study with a mean follow-up time of 6 respectively 26 years

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Daniel Muder ◽  
Nils P. Hailer ◽  
Torbjörn Vedung
Keyword(s):  
Primary Outcome ◽  
Statistical Significance ◽  
Surface Replacement ◽  
Level Of Evidence ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Two Component ◽  
Pip Joint

Abstract Background The aim of our study was to compare the long-term outcome after perichondrium transplantation and two-component surface replacement (SR) implants to the metacarpophalangeal (MCP) and the proximal interphalangeal (PIP) joints. Methods We evaluated 163 joints in 124 patients, divided into 138 SR implants in 102 patients and 25 perichondrium transplantations in 22 patients. Our primary outcome was any revision surgery of the index joint. Results The median follow-up time was 6 years (0–21) for the SR implants and 26 years (1–37) for the perichondrium transplants. Median age at index surgery was 64 years (24–82) for SR implants and 45 years (18–61) for perichondium transplants. MCP joint survival was slightly better in the perichondrium group (86.7%; 95% confidence interval [CI]: 69.4–100.0) than in the SR implant group (75%; CI 53.8–96.1), but not statistically significantly so (p = 0.4). PIP joint survival was also slightly better in the perichondrium group (80%; CI 55–100) than in the SR implant group (74.7%; CI 66.6–82.7), but below the threshold of statistical significance (p = 0.8). Conclusion In conclusion, resurfacing of finger joints using transplanted perichondrium is a technique worth considering since the method has low revision rates in the medium term and compares favorable to SR implants. Level of evidence III (Therapeutic).

Results of Vascularized Joint Transfers from the Foot

1997 ◽  
Vol 22 (4) ◽  
pp. 492-498 ◽  
Author(s):  
G. DAUTEL ◽  
M. MERLE
Keyword(s):  
Joint Space ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Indications For Surgery ◽  
Pip Joint ◽  
Prosthetic Implant ◽  
Metatarsophalangeal Joints ◽  
Second Toe ◽  
The Average Range

We report our results in ten cases of vascularized joint transfer to reconstruct the proximal interphalangeal joint (five cases) or metacarpophalangeal joints (five cases). Donor sites were the proximal interphalangeal or the metatarsophalangeal joints of the second toe. Indications for surgery were the need to reconstruct both the growth plate and joint space in children or the impossibility of a conventional prosthetic implant. The average range of motion was 44° for the PIP joint and 53° for the MP joint at a mean follow-up of 22.7 months.

SOLITARY PERIOSTEAL CHONDROMA PRESENTING AS A SNAPPING FINGER: AN UNUSUAL LOCATION

Hand Surgery ◽  
2008 ◽  
Vol 13 (02) ◽  
pp. 51-54 ◽  
Author(s):  
Toru Yamauchi ◽  
Osamu Oshiro ◽  
Shuji Hiraoka
Keyword(s):  
Unusual Case ◽  
Correct Diagnosis ◽  
Ring Finger ◽  
Extensor Tendon ◽  
Ct Scans ◽  
Unusual Location ◽  
Periosteal Chondroma ◽  
Pip Joint

We report an unusual case of a solitary periosteal chondroma presenting as a snapping finger and pain in the ring finger in a 37-year-old man. The snapping symptom was caused by impingement of this solitary chondroma. In this case, the periosteal chondroma was detached due to a finger sprain. Thus, the solitary chondroma was impinged between basal phalanx and extensor tendon, causing the pain and snapping finger. When patients with snapping finger present, CT scans can be helpful to make a correct diagnosis. To the best of our knowledge, this condition has not been described in the PIP joint.

Radiographic goniometry of the PIP-joint: A reliable measurement method

2020 ◽  
Author(s):  
Pauline D.H.M. Verhaegen ◽  
Lynn T. Kemper ◽  
Sander M. Brink ◽  
Tjeerd R. de Jong
Keyword(s):  
Measurement Method ◽  
Reliable Measurement ◽  
Pip Joint

Camptodactyly: A Finger Deformity in a Young Violinist

2000 ◽  
Vol 15 (2) ◽  
pp. 75-78
Author(s):  
Gerald P Melchor ◽  
Alice G Brandfonbrener
Keyword(s):  
Case Report ◽  
General Population ◽  
Surgical Correction ◽  
Flexion Deformity ◽  
Pip Joint ◽  
Congenital Condition ◽  
The Right ◽  
Little Finger

This report documents a congenital condition previously undescribed in a young musician. Uncommon and affecting between 1% and 2% of the general population, camptodactyly is an atraumatic, congenital flexion deformity of the proximal interphalangeal (PIP) joint of the finger, most often the right little finger, as seen in our patient.1 While this condition is not normally of great significance, except when present as part of a wider syndrome, its occurrence as described in this case report has great implications for musicians in that it may have detrimental effects on their ability to perform. Attempts at surgical correction of such a defect, in itself controversial, might further affect a musician’s ability to return to performance as well as to continue studying his or her instrument.

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.

Pins and Rubbers Traction System

1997 ◽  
Vol 22 (6) ◽  
pp. 730-735 ◽  
Author(s):  
X. de SORAS ◽  
P. de MOURGUES ◽  
D. GUINARD ◽  
F. MOUTET
Keyword(s):  
Reasonable Cost ◽  
Joint Fractures ◽  
Pip Joint ◽  
Traction System ◽  
Mobile Frame ◽  
Immediate Mobilization

The Pins and Rubbers Traction System (PRTS) is a mobile frame created with wires to support elastic traction, which produces a ligamentotaxis effect in the same direction and of the same intensity whatever the position of the joint. This technique has been used in 11 cases of complex PIP joint fractures with eight excellent results. The advantages are simplicity, adaptability, the possibility of immediate mobilization, reasonable cost and relatively small bulk.

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