• Archives of Plastic Surgery
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• v.50 no.2
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• pp.216-219
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• 2023

Neisseria gonorrhoeae is the most common sexually transmitted disease in the world and is known to cause disseminated disease, most commonly tenosynovitis. Classically, gonorrhea-associated tenosynovitis presents with concomitant dermatitis and arthralgias, though this is not always the case. N. gonorrhoeae-related tenosynovitis has become more commonly seen by hand surgeons. To aid in management, we present three cases of gonorrhea-induced tenosynovitis spanning a range of presentations with variable treatments to demonstrate the variety of patients with this disease. Only one of our patients had a positive gonococcal screening test and no patient had purulent urethritis, the most common gonorrhea-related symptom. A separate patient had the classic triad of tenosynovitis, dermatitis, and arthralgias. Two patients underwent operative irrigation and debridement, and one was managed with anti-gonococcal antibiotics alone. Though gonorrhea is a rare cause of flexor tenosynovitis, it must always be on the differential for hand surgeons when they encounter this diagnosis. Taking an appropriate sexual history and performing routine screening tests can assist in the diagnosis, the prescription of appropriate antibiotics, and potentially avoiding an unnecessary operation.

• Archives of Plastic Surgery
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• v.37 no.5
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• pp.708-711
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• 2010

Purpose: The sheath of tendon is uncommon site of tuberculous involvement as compared to other parts of the body. Especially, tuberculous tenosynovitis affecting flexor tendon of the hand is a rare condition. In recent years, furthermore, the incidence of tuberculosis is increasing in our country. Tuberculous tenosynovitis is a chronic, slowly destructive disease, which is difficult to diagnosis before operation, but can be definitively diagnosed by the pathologic microscopic examination. Early detection and surgical excision combined with antituberculous medication is important. We report a rare case of tuberculous tenosynovitis of the flexor tendon of the hand. Method: A 12-year-old woman presented with a painless, nontender mass on palmar side between distal interphalangeal joint and proximal area of metacarpophalangeal joint of the left third finger. We had surgical excision of the involved flexor tendon sheath and studied histopathologically. Result: The histopathological findings were chronic granulomatous inflammation with caseating necrosis consistent with tuberculosis. We started antituberculous medication. Conclusion: Tuberculous tenosynovitis is a rare condition, especially involving on the flexor tendon of the hand. But because of increasing tendency of tuberculosis, it is important to differentiate it from other tumors of the hand.

• Journal of Acupuncture Research
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• v.34 no.3
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• pp.71-90
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• 2017

Objectives : This study was performed to review articles concerning acupuncture and moxibustion treatment for De Quervain's Stenosing Tenosynovitis. Methods : On-line databases including Cochrane Library, Pubmed, CNKI, NDSL and OASIS were searched to identify articles concerning acupuncture and moxibustion treatment for De Quervain's Stenosing Tenosynovitis (DQST). Several duplicated articles and those not relevant to this topic were excluded, as were review articles and commentaries. Results : Fifty-one studies were identified, which included 28 clinical case studies with 1,227 patients and 23 randomized controlled trials with 2,040 patients. In these studies, acupuncture, acupotomy, moxibustion, pharmacopuncture, and laser acupuncture were used as DQST interventions. Although DQST is a common disease seen in clinical practice, only four of the 51 studies we identified in our search were published in Korean academic journals, all of which used pharmacopuncture. Conclusion : Although the results of the studies to date provide evidence that acupuncture and moxibustion are effective treatments for De Quervain's Stenosing Tenosynovitis, the absence of a standard, objective evaluation tool, and a lack of reporting on the negative side-effects associated with treatment remain important factors that should be addressed in future studies.

• Journal of Korean Foot and Ankle Society
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• v.17 no.2
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• pp.150-153
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• 2013

An enlarged peroneal tubercle causes lateral ankle and foot pain, and which is a cause for stenosing peroneal tenosynovitis. In this report, we present a case of stenosing tenosynovitis of the peroneus longus tendon associated with hypertrophy of the peroneal tubercle without involvement of the peroneus brevis tendon. Surgical excision of the enlarged peroneal tubercle along with exploration of the peroneal tendons was successful.

• Clinics in Shoulder and Elbow
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• v.17 no.2
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• pp.80-83
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• 2014

A 29-year-old man visited our clinic owing to a persistent swelling in the anterior part of the left elbow joint that began one year ago. Through magnetic resonance imaging (MRI), we observed tenosynovitis with multiple rice bodies, and so we performed an excisional biopsy and tenosynovectomy. Through pathology and culture tests, we identified tuberculosis in the tissue biopsy that we harvested intraoperatively. Following the anti-tuberculosis medication relieved the patient's symptoms without recurrence. Since tuberculosis of the elbow occurs only rarely, and the symptoms mimic those of rheumatoid synovitis or of non-specific chronic synovitis, early diagnosis and appropriate treatment are often delayed. The authors report this rare case of tuberculous tenosynovitis of the elbow with a review of the relevant literature.

• Journal of Korean Foot and Ankle Society
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• v.22 no.3
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• pp.131-134
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• 2018

A hypertrophied peroneal tubercle can present as a bony prominence at the lateral aspect of the foot and a peroneal tenosynovitis or tear. We report a case of a 52-year-old man complaining of lateral foot tingling pain and numbness. The sural nerve entrapment and peroneus longus tenosynovitis by hypertrophied peroneal tubercle were confirmed. Good results were obtained after excision of the hypertrophied peroneal tubercle and sural nerve release.

• Journal of Veterinary Clinics
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• v.33 no.1
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• pp.1-5
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• 2016

Septic tenosynovitis of the digital flexor tendon sheath (DFTS) is a potentially career-ending and life-threatening problem in horses. This study aimed to describe the outcomes of tenoscopy for the treatment of acute septic digital flexor tenosynovitis in horses. Tenoscopy was performed on 13 Thoroughbred horses with acute septic tenosynovitis of the DFTS. Surgical time was 56-148 min (mean 85.6 min, median 84.0 min). In the synovial fluid analysis, mean white blood cell count, mean neutrophil proportion, and mean total protein were $42.9{\times}10^3cells/{\mu}l$ (range, $7.2-109.5cells/{\mu}l$), 89.5% (range, 68-97%), and 4.0 g/dl (range, 2.5-5.2 g/dl), respectively. Microbial growth in the synovial fluid culture was detected in 2 of 11 horses. All horses survived and returned to their intended use without complications. The present study demonstrated that the tenoscopy is useful for treating acute septic tenosynovitis of the DFTS in horses.

• Journal of Korean Medicine Rehabilitation
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• v.31 no.4
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• pp.211-219
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• 2021

This study reports the effectiveness of Korean medicine and Chuna manual therapy on patients with De Quervain's tenosynovitis. Two patients were treated with Chuna manual therapy, electro-acupuncture, moxibustion therapy. We used numeric rating scale (NRS), Finkelstein's test, sonography to measure changes during treatment. After each treatment, NRS, Finkelstein's test, sonography outcome were improved. Korean medicine including Chuna manual therapy can be effectively used to improve De Quervain's tenosynovitis. This study may suggest that korean medicine including Chuna manual therapy can be effective for De Quervain's tenosynovitis.

• Journal of Korean Foot and Ankle Society
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• v.17 no.4
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• pp.294-301
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• 2013

Purpose: To report the clinical outcomes and complications of flexor hallucis longus (FHL) tendoscopy using 3 portals. Materials and Methods: Between January 2012 and April 2013, 10 patients (10 ankles) received tendoscopic surgery for the treatment of FHL tenosynovitis. Patients complaining of pain and tenderness along the course of FHL despite over 6 months of conservative treatments were indicated for surgery. The mean age was 41.7 years (range: 18-57) and the follow up period was 12.7 months (range: 6-20). Tendoscopy was performed using posteromedial, posterolateral, and plantar portals. Clinical evaluations included preoperative and postoperative visual analogue scale (VAS), American orthopaedic foot and ankle society (AOFAS) score, and patients' satisfaction. Results: Tendoscopic findings included tenosynovitis in 10 cases, degenerated vinculae in 6 cases, stenosis of the tendon at its entrance into the fibro-osseous tunnel in 5 cases, and degenerative partial tendon tear in 3 cases. Two cases had associated symptomatic os trigonum and 3 cases had posterior ankle impingement syndrome. Preoperative pain decreased from median VAS 6 (range: 4-10) to 2.1 (range: 1-5) at the last follow up and AOFAS score improved from 50.1 (range: 36-63) to 82.1 (range: 61-89) (p<0.05). Nine patients were satisfied or very satisfied with the outcome. Injury of the lateral plantar nerve occurred in one case. Conclusion: FHL tendoscopy using 3 portals is a feasible and useful minimal invasive surgical technique for the management of FHL tenosynovitis.

• Archives of Plastic Surgery
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• v.37 no.3
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• pp.304-308
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• 2010

Purpose: Many causes for triggering or locking of the fingers have been discussed in other literatures. The most common one is known stenosing tenosynovitis, which causes, a mismatch between the volume of the flexor tendon sheath and its contents. However, repeated trauma to the hand is uncommon cause of trigger finger. Therefore, we present a case of a rare condition of stenosing tenosynovitis which developed from a repeated relatively weak superficial flexor tendon injury. Methods: The patient was a 62-year-old woman who showed a painless, fixed and round mass on her right hand with no particular cause. Active and passive range of motion of the metacarpophalangeal joint of long finger was limited in flexion and extension. Ultrasonographic finding showed injured flexor digitorum superficialis tendon had fibrillar architecture with swelling between hyperechoic synovial membrane and hypoechoic surrounding area. Surgical exploration revealed that a bunched portion of the flexor digitorum superficialis and A1 pulley cause triggering during operation after adhesiolysis of scar tissue. Results: After releasing the A1 pulley, the range of motion of the metacarpophalangeal joint of long finger showed no limitation and histological examination of the subcutaneous tissue revealed fibrous fatty degeneration. In this case, releasing the A1 pulley with adhesiolysis of the subcutaneous scar tissue was successful and we obtained good functional outcome. Conclusion: We examined a patient in whom a repetitive impact forces to the palm caused longitudinal tear of the flexor tendon, leading to trigger finger. We experienced a rare case of stenosing tenosynovitis and trigger finger caused after close injury to flexor digitorum superficialis and its degenerative changes that caused mass like effect. To the best of authors' knowledge, our case of close injury to the flexor digitorum superficialis and unique morphologic change before rupture of tendon is rarely to be reported.