Granulomatous tenosynovitis: A rare musculoskeletal manifestation of tuberculosis

A patient with tenosynovial tuberculosis affecting the extensor tendons of the wrist and hand is presented. This case highlights the clinical and magnetic resonance features of tuberculous tenosynovitis, and seeks to increase awareness of what may represent a resurgent musculoskeletal entity.     

依托芬那酯凝胶治疗腱鞘炎超声引导下微创术后临床观察

目的评价依托芬那酯凝胶治疗腱鞘炎在超声引导下微创术后肿痛的有效性和安全性。方法采用随机、对照的设计,将2011年5月-2012年7月,在四川省人民医院门诊接受腱鞘炎超声引导微创术后的患者157例,分为两组,治疗组（n=81）采用依托芬那酯凝胶外用,对照组（n=76）不使用外用药物。结果两组治疗后24h及3d的疼痛评分、压痛及关节功能缓解率与治疗前自身比较及组间比较,差别均有统计学意义（P〈0．05）,7d时治疗组临床总有效率为90．12％,对照组为89．47％,组间比较无统计学意义（P〉0．05）,治疗组在使用应急药物上明显优于对照组。两组安全性评价比较差异无统计学意义（P〉0．05）。结论依托芬那酯凝胶能快速、有效、安全地缓解腱鞘炎超声引导微创术后局部肿胀疼痛的症状。     

Imaging techniques in rheumatology: sonography in rheumatoid arthritis

Musculoskeletal ultrasonography has become an important diagnostic tool in rheumatoid arthritis. In Germany it is part of the rheumatology training, and many ultrasound courses provide further education. Only in the last five years the international importance of ultrasound in rheumatology has increased dramatically. Sonography can be performed as a bedside procedure and as an extension of the clinical investigation. It is easily tolerated by the patients, and it can be repeated any time. Sonography can have a great impact on therapeutic decisions. A > or = 5 MHz linear transducer is needed. Most transducers that are used for musculoskeletal ultrasound have about 7.5 MHz. Modern transducers with higher frequencies (>7.5 MHz) and high resolution improve the diagnostic value of the investigation. Sonography is superior to plain radiography to detect erosions as far as the region is accessible by ultrasound. It is more sensitive than the clinical investigation for the detection of synovitis, tenosynovitis, tendinitis, and bursitis as well as for the differentiation of these lesions. Color Doppler sonography aids in evaluating the activity of inflammation and in differentiating intraarticular structures. Carpal- and ulnar neuropathy occur secondary to rheumatoid arthritis and may lead to characteristic nerve swelling. Ultrasound-guided injections into joints and tendon sheets can be performed.     

A prolonged case of<Emphasis Type="Italic"> Mycobacterium marinum</Emphasis> flexor tenosynovitis: radiographic and histological correlation,and review of the literature

We report on a 30-year-old man with prolonged Mycobacterium marinum flexor tenosynovitis. Due to low clinical suspicion, diagnosis was not made until 8 years after initial presentation. The history and magnetic resonance and tissue examination findings are consistent with mycobacterial tenosynovitis. These findings are presented, together with a review of the literature.     

The universal muscular chain reaction,muscle spasm,Torsions, ruptures and extravasations. Chameleons of pathology and some manifestations of simple muscular disorders

Most bodily functions require the coordinated actions of complementary and supplementary paired muscle groups. Where this essential muscular cooperation is lacking, hollow organs may burst and others become literally screwed up, giving rise to many similar spastic diseases such as Torticollis, Twisted ovarian cyst, Torsion of the Testis, Volvulus of the intestines, Varicose Veins, Megacolon, Aortamegaly, Scoliosis, Erb's Palsy, Peyronie's Disease, Main-en-Griffe, Undescended Foot (Pes Cavus), Talipes, Strabismus. Spasm is “panenepidemic” and unclassified examples of Torsion Dystonia and Dyskinesia really are as common as debt and taxes.     

Reliability of a vibration test in screening for predisposition to tenosynovitis

Summary The reliability of a vibration test has been studied in terms of its feasibility for screening for predisposition to tenosynovitis in an occupational health setting. In a worker population with a high prevalence of tenosynovitis the specificity and sensitivity of the method in the best cases were 68% and 50%, respectively. In an apparently healthy population there were significant interindividual differences; but in successive trials the same individual could have index values indicating both a predisposition and a lack of predisposition for tenosynovitis. The index value seems to be dependent on the temperature of the test room. It was concluded, in contrast to earlier results, that the vibration test is, of no value in screening for a predisposition to tenosynovitis in an occupational health setting.     

痛点注射与针刀治疗屈指肌腱狭窄性腱鞘炎的临床观察

目的观察痛点注射与针刀治疗屈指肌腱狭窄性腱鞘炎的临床效果。方法将 119例屈指肌腱狭窄性腱鞘炎患者随机分成2组,A组为对照组56例,采用消炎镇痛液局部痛点注射治疗;B组为观察组63例,根据临床症状轻重分成Ⅰ、Ⅱ、Ⅲ、Ⅳ4度,Ⅰ度采用痛点注射疗法,Ⅱ、Ⅲ、Ⅳ度采用痛点注射加针刀疗法。结果 A组与B组治愈者分别为20例(35．7％)与 52例(82．5％),有效者分别为44例(81．5％)与61例(96．8％),治愈率及有效率B组明显高于A 组(P<0．01),无效率(A组12例,21．4％;B组2例3．2％)及复发率(A组15例,36．4％;B组1例, 1．6％),B组明显低于A组(P<0．01)。结论痛点注射疗法对屈指肌腱狭窄性腱鞘炎症状较轻、病程较短的Ⅰ度患者疗效高,且损伤小。痛点注射加针刀疗法对Ⅱ、Ⅲ、Ⅳ度患者的疗效好,且不易复发。     

Co-occurrence of poststreptococcal reactive arthritis and acute glomerulonephritis

We report a 16-year-old patient who developed concurrent poststreptococcal reactive arthritis and acute glomerulonephritis. A high titer of antistreptolysin O antibody confirmed the preceding streptococcal infection. The patient presented with symmetric persistent tenosynovitis of hands and feet. Renal biopsy showed typical findings of acute glomerulonephritis with crescent formation. Physicians who treat patients with arthritis of acute onset, especially after throat infection, should be aware of possible urinary abnormalities or renal dysfunction.