Re: Attrition rupture of the flexor pollicis longus in rheumatoid arthritis on an interphalangeal sesamoid bone

Sesamoid Disorders of the Hand

“…Flexor pollicis longus (FPL) rupture secondary to attrition on a thumb sesamoid at the MCP joint has been previously reported. 14, 15 Valbuena et al 14 reported FPL rupture secondary to attrition on a sesamoid bone at the level of the IP joint. Although very rare, tumors and avascular necrosis of the sesamoid bones have also been reported in the literature.…”

A symptomatic sesamoid bone in the popliteus muscle (cyamella)

“…Sesamoid bones may be asymptomatic or symptomatic, causing considerable pathology [2]. They may perform bony or cartilaginous pseudoarticular connections with their neighbouring bones that in case of an osteoarthritic destruction of these articulations may be a cause of considerable pain and rupture of the tendon involved as is described clinically and radiologically [4,5].…”

Rupture of the Flexor Pollicis Longus Tendon from the Metacarpophalangeal Sesamoid and Joint in a Rheumatoid Patient

“…Mannerfelt also reviewed tendon ruptures over a 5-year period, and 20 of 25 flexor tendon ruptures were FPL and occurred in the carpal tunnel 2 . In reviewing the literature, there are only 2 other descriptions of FPL rupture from attritional damage due to sesamoids in the rheumatoid patient: one secondary to the ulnar sesamoid at the MCP joint 5 and another due to an IP joint sesamoid 6 . The patient described here sustained a rupture of the FPL likely secondary to attritional damage from exostoses from the radial sesamoid and MCP joint.…”

“…Walker described a rheumatoid patient who sustained FPL rupture secondary to attritional damage from an ulnar sesamoid at the level of the metacarpophalangeal (MCP) joint 5 . Valbuena described FPL rupture in a rheumatoid patient at the thumb interphalangeal (IP) joint from attritional damage secondary to an IP sesamoid 6 . In reviewing the literature, there was only one other report of an FPL rupture from attritional damage secondary to a sesamoid, and this was an ulnar MCP sesamoid in a non-rheumatologic patient due to osteoarthritic changes 7 .…”