Isolated tuberculous tenosynovitis of the flexor tendon of the fourth finger of the hand. Case report.

A 21-year-old woman presented with a painful swelling of her palm which prevented her from fully extending her fourth finger. Magnetic resonance imaging showed synovial thickening around the flexor tendon and fluid in the tendon sheath. The mass was excised and histopathological examination showed tuberculosis. She had a six-month course of antituberculous treatment and was perfectly well three years later.     

Isolated tuberculous tenosynovitis of the Achilles tendon. A case report

The diagnosis of isolated tuberculosis of the Achilles tendon was made in a 50-year-old man by excision of the lesion and histologic examination. The patient was free of other systemic symptoms or other foci of infection. The wound healed without complication with the aid of antituberculous chemotherapy. The lesion recurred after nine years, at which time it was again excised and the diagnosis confirmed. Eight years later, the patient remains symptom-free with no signs of recurrence.     

Sarcoid flexor tenosynovitis of the finger: a case report

A case report of flexor tenosynovitis of the right ring finger in a 27-year-old black woman leading to the diagnosis of sarcoidosis is presented. Sarcoidosis of a flexor tendon sheath is rare. Flexor tenosynovectomy provided material for histologic diagnosis and increased the function of the hand.     

Closed tendon sheath irrigation for pyogenic flexor tenosynovitis

Twenty patients with pyogenic flexor tenosynovitis were treated by through-and-through saline irrigation using an indwelling catheter and small Penrose drain. The treatment lasted for 48 hours. All patients were discharged from the hospital within 4 days. Eighteen patients had regained complete active and passive motion by 1 week after operation. One patient had a slight residual flexor tendon adherence and one gained motion after operation. This technique provides rapid, complete return of function with minimal inconvenience to the patient.     

A flexor tendon rupture in the palm of the hand

Traumatic, subcutaneous ruptures of flexor tendons in the hand are infrequent findings in clinical practice. They usually occur at the bony insertion or at the musculotendinous junction. Intratendinous ruptures are reported almost only in association with underlying pathologic conditions. We report a case of subcutaneous rupture through the healthy substance of the profundus flexor tendon of the small finger in the palm of the hand, which was associated with a complete tendinous fusion between the deep flexor of the ring and small finger up to the lumbrical insertion.     

Isolated tuberculous tenosynovitis of the flexor carpi ulnaris: a case report and review of literature

Musculoskeletal involvement is seen in only about 1.3% of all patients with tuberculosis. Very few cases of isolated tuberculous synovitis have been reported. The rarity of this condition often leads to the failure to consider tuberculosis in the differential diagnosis, resulting in delayed therapy. We present one such case of isolated tuberculous tenosynovitis of the flexor carpi ulnaris in an otherwise healthy, 17-year-old female, which healed completely on conservative treatment.     

Two-stage flexor tendon reconstruction in the hand

The results of two-stage flexor tendon reconstruction in the hand, evaluated in 25 fingers in 20 patients with an average followup of 5 months, were graded on the basis of total range of active flexion and combined extension loss. Two-stage flexor tendon reconstruction can significantly improve the functional status of fingers with extensive damage or scarring of the flexor mechanism. Function was generally improved despite the preoperative status of the digit, but a completely normal flexion range can be restored only in rare instances. Poor results were noted in 8 patients. The likelihood of success may be predictably less in patients with a prolonged interval between injury and reconstruction, joint contractures, synovitis following stage-one, multiple grafts, and advanced age.     

Mycobacterial tuberculous tenosynovitis of the extensor tendon occurring after liver transplantation: a case report

Mycobacterial tuberculous tenosynovitis of the hand is a rare manifestation of extrapulmonary tuberculosis, while mycobacterial tuberculous tenosynovitis of the extensor tendon sheath is extremely rare. We report a case of tuberculous tenosynovitis of the extensor tendon of the finger, occurring in a man receiving immunosuppression following a liver transplantation. Symptoms improved clinically after conservative treatment with anti-tuberculous drugs.     

Sesamoiditis of the index finger presenting as acute suppurative flexor tenosynovitis

Sesamoiditis involving the hand is uncommon, usually reported in the thumb, and has not been reported in the index finger. As rare as this clinical entity remains, its presentation simulating an acute suppurative flexor tenosynovitis is even more rare. We report a patient who presented with Kanavel's 4 cardinal signs of acute suppurative tenosynovitis who was subsequently found to have an acute sesamoiditis of the index finger. This finding was supplemented by a cadaveric and radiographic study to better delineate the anatomy of the index sesamoid and further explain the clinical presentation.     

Stenosing tenosynovitis of the flexor hallucis longus tendon at the sesamoid area

The author presents a case of stenosing tenosynovitis of the flexor hallucis longus tendon at the sesamoid area of the great toe following injury of the hallux. Although stenosing tenosynovitis of the flexor hallucis longus tendon is not rare, occurring frequently in ballet dancers, its entrapment at the sesamoid area was rarely described in the literature. Early recognition of this condition is very important for successful treatment. This patient did not respond to nonoperative treatment and surgical tenolysis was very successful for relief of the symptoms.