Sarcoid tenosynovitis in the hand a case report and literature review

Abstract

We report a case of involvement of a finger flexor tendon by sarcoidosis. A review of twelve cases suggests that this is a rare manifestation of the illness that most often affects the finger extensors at the wrist. It tends to present in established sarcoidosis and is associated with a higher than usual incidence of polyarthritis. The main differential diagnosis would be tuberculous tenosynovitis. We suggest that a histological spectrum exists running from a predominantly cellular picture to one of fibrotic nodules, perhaps explaining previously described instances of pseudo-tumour. We would recommend tenosynovectomy in conjunction with corticosteroid therapy as the treatment of choice.

Multiple Unusual Complications After Extensive Chronic Sarcoid Tenosynovitis of the Hand: A Case Report

“…8 Tenosynovectomy alone without subsequent medical management of the condition with steroids leads to a recurrence. 3 Worsening of the disease from a diffuse cellular pattern to an extensive nodular involvement has been reported in a patient who refused steroids. 6 Most cases of sarcoid tenosynovitis that have been treated with systemic steroids appear to have resolved without complications.…”

“…2 Tenosynovitis of the hand is rare and less than 20 cases have been published so far in the English literature. [1][2][3][4][5][6][7] Of these the extensor tendons have been reported to be involved more commonly than the flexors. 3,4 There is a solitary report of an attritional rupture of the extensor pollicis longus after intraosseous in- volvement of the distal radius.…”

“…[1][2][3][4][5][6][7] Of these the extensor tendons have been reported to be involved more commonly than the flexors. 3,4 There is a solitary report of an attritional rupture of the extensor pollicis longus after intraosseous in- volvement of the distal radius. 5 Our patient had the unusual complication of a spontaneous rupture of the flexor digitorum profundus tendon of the right index finger when he presented to us the second time.…”

“…1 Involvement of the hand is extremely uncommon and tenosynovitis is rare. [1][2][3][4][5][6][7] Skeletal involvement is well known but has been reported to characteristically spare the subchondral bone. 8 We report a case of sarcoid tenosynovitis of the hand that presented with the complications of flexor tendon rupture, subchondral bone erosions, and multiple joint subluxations.…”

Future Perspectives in Nerve Repair and Regeneration

“…Injury to peripheral nerves always results in immediate loss of muscle function and progressive skeletal muscle atrophy, thus representing an important cause of poor clinical results after nerve reconstruction. Following a peripheral nerve injury, the longer the interval between denervation and reinnervation, the poorer the degree of motor recovery; thus, the regenerative outcome may be very poor when reinnervation of denervated target organs is delayed due either to a long distance between target and lesion site or to delayed nerve repair following major trauma (Birch & Raji, 1991;Merle, Bour, Foucher, & Saint Laurent, 1986). Since axons usually regrow at an average rate of 1 mm/day (Buchthal & Kuhl, 1979;Seddon & Fynn, 1972), it would take a long time for the muscle to be reinnervated.…”