Browse
Submit Data
Databases
API
Help

Dataset Information

0 Views

0 Connections

0 Citations

0 Reanalyses

0 Downloads

Omics score: 0

Dynamic Ultrasound Examination for Extensor Pollicis Longus Tendon Rupture after Palpation-Guided Corticosteroid Injection.

ABSTRACT: This report aimed to present a case of wrist-tendon rupture and to discuss a rare complication after corticosteroid injection. A 67-year-old woman had difficulty extending her left-thumb interphalangeal joint several weeks after a palpation-guided local corticosteroid injection. Passive motions remained intact without sensory abnormalities. Ultrasound examination showed hyperechoic tissues at the site of the extensor pollicis longus (EPL) tendon at the wrist level and an atrophic EPL muscle stump at the forearm level. Dynamic imaging demonstrated no motion in the EPL muscle during passive thumb flexion/extension. The diagnosis of complete EPL rupture, possibly due to inadvertent intratendinous corticosteroid injection, was therefore confirmed.

SUBMITTER: Chen YC

PROVIDER: S-EPMC10001071 | biostudies-literature | 2023 Mar

REPOSITORIES: biostudies-literature

ACCESS DATA

Json Xml

Publications

Dynamic Ultrasound Examination for Extensor Pollicis Longus Tendon Rupture after Palpation-Guided Corticosteroid Injection.

Chen Ying-Chun YC Wu Wei-Ting WT Mezian Kamal K Ricci Vincenzo V Özçakar Levent L Chang Ke-Vin KV

Diagnostics (Basel, Switzerland) 20230303 5

This report aimed to present a case of wrist-tendon rupture and to discuss a rare complication after corticosteroid injection. A 67-year-old woman had difficulty extending her left-thumb interphalangeal joint several weeks after a palpation-guided local corticosteroid injection. Passive motions remained intact without sensory abnormalities. Ultrasound examination showed hyperechoic tissues at the site of the extensor pollicis longus (EPL) tendon at the wrist level and an atrophic EPL muscle stum ...[more]

PMID: 36900103

Similar Datasets

Distal intersection syndrome progressing to extensor pollicis longus tendon rupture: a case report with sonographic findings.

Project description:The purpose of this case report is to describe the value of musculoskeletal ultrasound (US) in diagnosing both distal intersection syndrome (DIS) and rupture of the extensor pollicis longus (EPL) tendon in the same patient. A 38-year-old female presented for evaluation of a painful bump of unknown etiology on the dorsolateral aspect of her non-dominant wrist. US demonstrated tenosynovitis distal to Lister's tubercle of the EPL and extensor carpi radialis tendon sheaths, consistent with DIS. Immobilization therapy was employed, during which time the patient suffered rupture of the EPL tendon. Follow-up US examination confirmed this additional diagnosis. Characteristic US findings of DIS and EPL tendon rupture were observed. Surgical intervention was required and the patient recovered without complication. Although EPL rupture is relatively common in the literature, DIS is rare. This is the first known case of imaging-proven DIS progressing to EPL tendon rupture. This case underscores the value of US as a widely available, cost effective, and dynamic imaging modality for evaluation of wrist complaints.

| S-EPMC5573695 | biostudies-literature

Accessory Extensor Pollicis Longus Tendon Incidentally Discovered During Dorsal Distal Radius Plating.

Project description:Anatomical variations of the extensor pollicis longus (EPL) tendon are rare. Variations are typically asymptomatic, yet knowledge of these variations poses significance in the setting of dorsal approaches to wrist surgery. We present a case of an accessory EPL tendon that was discovered intraoperatively in the fourth dorsal compartment during open repair of a distal radius fracture with a dorsal spanning plate. If not correctly identified, the accessory EPL could have been entrapped beneath the plate, resulting in limited thumb extension and potentially tendon rupture.

| S-EPMC10837286 | biostudies-literature

Differential sonographic features of the extensor pollicis longus tendon rupture and other finger tendons rupture in the setting of hand and wrist trauma.

Project description:PurposeTo investigate the difference between sonographic findings in extensor pollicis longus tendons rupture and other finger tendons rupture in patients sustaining hand and wrist trauma.MethodsTwenty-four patients who presented with signs and symptoms clinically suspicious for tendon injury and surgically confirmed tendon rupture were included in this study. We analyzed 6 sonographic features: discontinuity of the tendon, pseudomass formation, decreased echogenicity of the tendon, retraction of the ruptured tendon, fluid collection within the tendon sheath, and the motion of the tendon. We compared the sonographic features of ruptured extensor pollicis longus tendons with the other ruptured finger tendons.ResultsDiscontinuity of the tendon was the most common sonographic findings and retraction of the ruptured tendon was the second most common findings. Fourteen of 16 cases with a dynamic study on sonography showed loss of normal motion of the tendon. Pseudomass formation was the second most common feature in ruptured extensor pollicis longus tendons, in contrast to the other ruptured finger tendons (p < 0.05).ConclusionUsing ultrasonography, detection of discontinuity of the tendon, retraction of the ruptured tendon, and limitation of tendon motion could be very helpful for diagnosing a tendon rupture in hand and wrist trauma. Pseudomass formation could be more specific for diagnosing extensor pollicis longus tendon ruptures compared with other finger tendons.

| S-EPMC6168155 | biostudies-literature

Flexor pollicis longus zone 2 tendon repair under WALANT with ultrasound assistance.

Project description:A feature of the flexor pollicis longus tendon injury is the frequency of palmar retraction so that a wrist approach is needed for retrieval of the proximal stump. We are reporting on our first outpatient zone T2 flexor pollicis longus tendon repair under WALANT with ultrasound guidance. In the event of zone T2 flexor pollicis rupture, ultrasound location of tendon extremities is used to plan surgical WALANT strategy and to guide the injection of lidocaine with epinephrine whilst limiting the injected volume to what is strictly necessary.

| S-EPMC7937827 | biostudies-literature

Spontaneous Rupture of Extensor Pollicis Longus Tendon: Clinical and Occupational Implications, Treatment Approaches and Prognostic Outcome in Non-Rheumatoid Arthritis Patients: A Retrospective Study.

Project description:Background:Spontaneous rupture of extensor pollicis longus (EPL) tendon is a rare condition often found in patients actively having regular extensive use of hands and fingers especially the thumb. In this article, we report 7 cases of spontaneous rupture of EPL tendon and investigate the associated factors and treatment outcome. Methods:Retrospectively, the databases for the 7 cases were retrieved and studied. These cases represent all cases of spontaneous rupture of EPL in our institution. Demographic data, clinical presentation, any history of trauma or steroid injection, laboratory and clinical findings suggestive for rheumatoid arthritis, co-morbidities and imaging findings were obtained. In addition, the operative technique and findings were retrieved. Moreover, histopathological studies and follow-up assessment were included. Results:Six males and one female were included. The mean age was 45.2 years. No prior history of trauma, rheumatological disease or steroid use was detected in any patient. All patients experienced prodromal pain in the radial side. Clinical examination was the most effective diagnostic measure. Magnetic resonance imaging (MRI) was used to confirm the diagnosis and to look for other abnormalities that may predispose to rupture. Five patients underwent extensor indicis proprius to EPL tendon transfer employing Pulvertaft weave technique and one patient underwent primary repair as there was a little gap in the tendon ends. In this study, one patient refused any treatment. All patients achieved a favorable outcome at the last follow?-up. Conclusion:Diagnosis of spontaneous ruptures of EPL tendon can be confirmed through clinical examination and MRI for patients with restricted thumb movement even with the absence of any identifiable predisposing risk factor. During surgery, detailed attention must be drawn towards the tendon ends which can have unusual gaps and bone abnormalities.

| S-EPMC7196201 | biostudies-literature

Extensor pollicis longus tendon penetration by a screw post-distal radius fracture plating in a young woman: A case report.

Project description:IntroductionDue to its ability to provide stable fixation and permit early mobilization, volar plating has become the recommended technique for the surgical stabilization of distal radius fractures. The extensor pollicis longus (EPL) tendon may be injured or ruptured as a result of undetected screw penetration or drill plunging. During surgery, it is critical to detect any potential screw penetration so that it can be corrected.Case presentationA 32-year-old woman presented six weeks post-distal radius plating with an inability to extend her left thumb. Clinical examination revealed loss of extension at the interphalangeal joint, stiff wrist, tender point over the dorsal aspect of the wrist, and an intact sensory nerve function.DiscussionDynamic ultrasound and magnetic resonance imaging (MRI) both revealed no evidence of tendon rupture or EPL tendon movement. X-rays revealed the distal epiphyseal screws penetrating the far cortex. Intraoperatively, the EPL tendon was found to be impinged by a screw. The tendon was released, tenolysis was performed, and the distal screws were shortened.ConclusionIn order to assess screw penetration into the far cortex, volar plating for distal radius fractures should be performed using intraoperative imaging views such as lateral, 45-degree supination, 45-degree pronation, dorsal tangential, and skyline views. Timely interventions after distal radius fracture fixation preserve tendon function, and early detection of tendon compromise is essential to preventing additional damage.

| S-EPMC11342871 | biostudies-literature

Ultrasound- versus palpation-guided injection of corticosteroid for plantar fasciitis: a meta-analysis.

Project description:BackgroundIt is controversial whether ultrasound-guided injection of corticosteroid is superior to palpation-guided injection for plantar fasciitis. This meta-analysis was performed to compare the effectiveness of ultrasound-guided and palpation-guided injection of corticosteroid for the treatment of plantar fasciitis.MethodsDatabases (MEDLINE, Cochrane library and EMBASE) and reference lists were searched from their establishment to August 30, 2013 for randomized controlled trials (RCTs) comparing ultrasound-guided with palpation-guided injection for plantar fasciitis. The Cochrane risk of bias (ROB) tool was used to assess the methodological quality. Outcome measurements were visual analogue scale (VAS), tenderness threshold (TT), heel tenderness index (HTI), response rate, plantar fascia thickness (PFT), hypoechogenicity and heel pad thickness (HPT). The statistical analysis was performed with software RevMan 5.2 and Stata 12.0. When I2<50%, the fixed-effects model was adopted. Otherwise the randomized-effects model was adopted. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) system was used to assess the quality of evidence.ResultsFive RCTs with 149 patients were identified and analyzed. Compared with palpation-guided injection, ultrasound-guided injection was superior with regard to VAS, TT, response rate, PFT and hypoechogenicity. However, there was no statistical significance between the two groups for HPT and HTI.ConclusionUltrasound-guided injection of corticosteroid tends to be more effective than palpation-guided injection. However, it needs to be confirmed by further research.

| S-EPMC3962443 | biostudies-literature

Flexor pollicis longus (FPL) tendon hypoplasia: A case report and literature review.

Project description:An 18-year-old female presented with long-standing inability to flex her left thumb. MRI of the left thumb revealed flexor pollicus longus (FPL) tendon hypoplasia, and subsequent ultrasound of the bilateral thumbs confirmed a left-sided hypoplastic FPL tendon. Structural integrity of the left FPL tendon was confirmed during surgical examination under anesthesia. Multiple congenital anomalies of the FPL have been described, but FPL tendon hypoplasia and its appearance on imaging are rarely reported. This case demonstrates the diagnosis of FPL tendon hypoplasia on MRI, ultrasound, and surgical examination under anesthesia; and demonstrates the importance of including this entity in the differential diagnosis for impaired thumb flexion.

| S-EPMC6402301 | biostudies-literature

Cause of Extensor Pollicis Longus Ruptures After Distal Radius Fracture Fixation Using a Volar Plate.

Project description:BackgroundThis research sought to analyze a cohort of patients with extensor pollicis longus (EPL) ruptures after volar locked plating of a distal radius fracture (DRF) to characterize the incidence of ruptures that are unlikely to be related to dorsal screw prominence.MethodsThis is a retrospective, observational, descriptive cohort study of adults with operative fixation of a closed DRF and an EPL rupture between 2002 and 2022. Eighteen patients with operative fixation using a volar plate of a closed DRF had an EPL rupture. The cohort consisted of 66% women with an average age of 57.5 years. Median follow-up was 14.5 months.ResultsThe incidence of EPL rupture was 0.4% (18/4768). The average time from DRF and DRF fixation to EPL rupture was 3.7 and 3.4 months, respectively. Based on the operative record, in 2 of the 18 patients (11%), the rupture was directly attributable to prominent hardware; however, in 4 of the 18 patients (22%), the rupture was not related to prominent hardware, and the cause was indeterminate in 12 patients (67%). Radiologic analysis of those in the indeterminate group demonstrated that 5 of the 12 patients had screws that had a high probability of being prominent.ConclusionsThe incidence of EPL rupture after volar plating of DRF is between 0% and 1% and usually occurs about 3 months after fixation. Approximately 50% of EPL ruptures are attributable to prominent dorsal screws. Although screw prominence is an important cause of EPL rupture, it is not the sole cause of rupture.

| S-EPMC11571553 | biostudies-literature

Biomechanical study of the abductor pollicis longus & extensor pollicis brevis after release and reconstruction of the first dorsal compartment of the wrist.

Project description:BackgroundThe purpose of this study was to determine the biomechanical changes after first dorsal compartment release and after Z-plasty of the first dorsal compartment with respect to the excursion and displacement of the abductor pollicis longus and extensor pollicis brevis tendons.Materials and methodsSix fresh frozen cadaveric hand and forearms were obtained and the tendons of the abductor were exposed and separated from surrounding tissues through a palmar incision and tenotomized at the musculotendinous junction. The excursion and displacement of the abductor pollicis brevis and flexor pollicis brevis tendons were measured for all six cadaveric hands.ResultsIncreases in tendon excursion were observed in both the abductor pollicis longus (29%) and extensor pollicis brevis (30%) while these observations after Z-plasty were 0.04% for abductor pollicis longus and 0.07% for extensor pollicis brevis. With the use of the modified Elftman curve for the Lengths, tension relationship and Brand's data for resting fiber length we found that 1 cm increase of The excursion of the APL and EPB will decrease tension %65 and %80 respectively. There was also a 12.2-mm displacement of the tendons after release and 4.8 mm displacement after z-plasty of the compartment.ConclusionIt seems that Procedures such as enlargement plasty of Kapandji or Z-plasty will increase the size of the compartment but will not change the biomechanical behaviors of the tendons significantly.

| S-EPMC8455358 | biostudies-literature

OmicsDI is part of the ELIXIR infrastructure

OmicsDI is an Elixir interoperability service. Learn more ›

Tweets

OmicsDI Databases

PRIDE
PeptideAtlas
MassIVE
JPOST Repository
Physiome Model Repository

EGA
EVA
ENA
LINCS
PAXDB
Cell Collective

MetaboLights
Metabolomics Workbench
MetabolomeExpress
GNPS
BioModels
FAIRDOMHub

ArrayExpress
dbGaP
ExpressionAtlas
GEO
NODE

Information

Databases
Help
API
Contact us
Code on GitHub
Terms of use
Submit Data