Ankle Extensor Tendon Synovitis Due to a Date Palm Thorn

Abstract

Palm thorn injury to tendons and joints is characterized in most patients by an acute inflammatory stage followed by a relatively asymptomatic period and finally by chronic synovitis or tenosynovitis. Once the inflammatory process has begun, detection and localization of the thorn can be very difficult. We present an unusual case of palm thorn tenosynovitis of the ankle extensor tendon which was detected and localized preoperatively by ultrasound. Removal of the thorn and synovectomy were curative.

Earlobe Inflammation from a Palm Thorn Injury

“…[3][4][5][6] These patients were treated in tertiary centers. In a series of eight patients who were treated in the community, it is apparent that treatment in the community is feasible and that palm tree injury causes a local pain syndrome than can persist for a long time (mean = 12.6 ± 5.9 weeks) even when the palm thorn is removed.…”

“…1,2 The incidence of palm tree injuries is apparently higher than that recognized in the literature since many cases are neither diagnosed nor reported. 3 Even when the source of the inflammation is diagnosed, appropriate treatment is usually delayed because family doctors are not familiar with the entity.…”

A systematic approach to medical decision-making of uncommon clinical pictures: A case of ulcerative skin lesions by palm tree thorn injury and a one-year follow-up

“…Irrigation of the joint with normal saline (five cases), arthrotomy and synovectomy (two cases) Nyska [13] Case report 1 Tenosynovitis of the ankle extensor tendon Removal of foreign body and synovectomy Cahill [14] Case series 10 Synovitis Primary extensive synovectomy or limited synovectomy (but this required subsequent extensive synovectomy) Carandell [15] Case report 1 Synovitis Articular irrigation Balasubramaniam [18] Case series 3 Pseudotumour of the hand, one case of periosteal reaction Surgical removal 208 S. Corrao et al…”

Date Palm Thorn Injury: A Literature Review and a Case Study of Extensive Hand Haematoma

“…Although they are associated with serious injuries from thorns, this type of injury remains underdiagnosed and is not extensively reported in the literature for numerous reasons. These include the tendency of children to be injured by an array of objects and the lack of a clear history of the injury, the ability of minute thorn particles to break off inside the tissue and be easily overlooked, and the radiolucent characteristics of the thorn pieces on X-ray film [2,3].…”

“…Making a clinical diagnosis of a date palm thorn injury can be challenging for the treating physician, especially when the injury history is unclear and the signs are nonspecific. Plain X-ray films cannot show the thorn pieces as they are radiolucent, but they help detect bone and joint changes, such as effusion and a periosteal reaction, which can be late presentations of this disease [3]. Ultrasound is more helpful in localising the thorn particles and soft tissue changes but requires a skilled operator [4].…”