Sea urchin spine arthritis in the foot

Abstract

We present a case of sea urchin spine arthritis (SUSA) in a 33-year-old woman who sustained penetrating trauma to the interphalangeal (IP) joint of the hallux while snorkeling in Japan. Serial radiographs and MRI were obtained over a period from 7 weeks to 10 months following injury. At 7 weeks radiographs revealed periarticular osteopenia and subtle marginal erosion, similar to the appearance of tuberculous arthritis. Over the ensuing months, radiographs and MRI documented progressive marginal and periarticular erosions with synovitis, despite preservation of cartilage space and restoration of bone mineral density. Delayed radiographs and imaging features mimic gouty arthropathy. Only the history points to the proper diagnosis, which was confirmed by histopathology, demonstrating necrobiotic granuloma with central fibrinoid necrosis following synovectomy and arthrodesis. The majority of previous case reports affected the hand, with few cases in the feet. In all, radiographic illustrations were limited and demonstrated only minimal osteolysis and periosteal reaction. No other report included MRI or serial radiographs over a long period to illustrate the natural progression of the disease.

Mycobacteriosis in Aquatic Invertebrates: A Review of Its Emergence

“…Existing reports on mycobacterial disease in this group are often related to human disease. A few have reported human cases of atypical mycobacterial infection caused by M. marinum , related to injuries from sea urchins in Spain [ 75 , 76 ], and Japan [ 77 ], ( Table 3 and Table 4 ). In another case, also resulting from a sea urchin, multiple small, raised nodules over the volar index finger and thumb extending to the palm resulted in tenosynovitis due to a penetrating injury to the hand caused by M. chelonae in Hawaii, USA [ 78 ], ( Table 3 and Table 4 ).…”

“…Spain [76] Sea urchin M. marinum Arthritis in the interphalangeal joint of the hallux while snorkelling in Japan. Fukuoka, Japan [77] Sea urchin M. chelonae…”

Arthroscopic Synovectomy of the Interphalangeal Joint of the Great Toe

“…Synovectomy with thorough debridement of the joint is the treatment of choice. 5 The interphalangeal sesamoid bone can also be symptomatic and present as painful hyperkeratotic lesions immediately plantar to the IPJ. 2 Sesamoidectomy is needed if conservative treatment fails to relieve the symptoms.…”

Surgical Implications of Preoperative Sonographic Localization of Sea Urchin Spine Foreign Bodies

“…Sea urchins are hard‐shelled animals covered with sharp spines; some sea urchins are venomous and toxic to humans 4 . The spines are composed of calcium carbonate and are very brittle and sharp 5 . The hand is most commonly injured by sea urchins 4 .…”

“…In our case, the patient had pain, substantial swelling, and the inability to fully flex her finger. Although several cases of erosive arthropathy 5 , 9 have been reported in the literature, sea urchin–induced tenosynovitis is less commonly reported 10 . Our patient had clinical signs of tenosynovitis requiring surgical exploration.…”