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Plant Thorn Synovitis
Authors:Michael Sugarman  Dennis G. Stobie  Francisco P. Quismorio  Roger Terry  Virgil Hanson
Abstract:Five children with an inflammatory monarthritis due to penetration of the joint by plant thorns are presented. The clinical presentation was that of a transient acute synovitis followed by a relatively asymptomatic period, and later by chronic arthritis often after the thorn injury was forgotten. Histopathology demonstrated a granulomatous synovitis. Polarized light microscopy facilitated identification of the plant tissue within the synovium. Conservative medical therapy was ineffective, but surgical excision of the affected synovium resulted in normal joint function. The differential diagnosis of monarthritis in children is extensive, and awareness of this condition is necessary to elicit a comprehensive history and to avoid delay in treatment.
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