PDF(Pubmed)
Abstract：
BACKGROUND: Sarcoidosis is a multisystem disease characterized by granuloma formation in various organs. Sarcoidosis-related flexor tendon contractures are uncommon in clinical settings. This contracture is similar to stenosing tenosynovitis and potentially leads to misdiagnosis and mistreatment. Herein, we report a rare case of sarcoidosis-related finger flexor tendon contracture that was misdiagnosed as tenosynovitis.
METHODS: A 44-year-old woman presented to our department with flexion contracture of the right ring and middle fingers. The patient was misdiagnosed with tenosynovitis and underwent acupotomy release of the A1 pulley of the middle finger in another hospital that resulted in iatrogenic rupture of both the superficial and profundus flexors. Radiological presentation showed multiple sarcoid involvements in the pulmonary locations and ipsilateral forearm. A diagnosis of sarcoidosis was made based on the presence of non-caseating granulomas with tubercles consisting of Langhans giant cells with lymphocyte infiltration on biopsy, and the patient underwent surgical repair for the contracture. After 2 mo, the patient experienced another spontaneous rupture of the repaired middle finger tendon and underwent surgical re-repair. Satisfactory results were achieved at the 10 mo follow-up after reoperation.
CONCLUSIONS: Sarcoidosis-related finger contractures are rare; thus, caution should be exercised when dealing with such patients to avoid incorrect treatment.
METHODS: A 44-year-old woman presented to our department with flexion contracture of the right ring and middle fingers. The patient was misdiagnosed with tenosynovitis and underwent acupotomy release of the A1 pulley of the middle finger in another hospital that resulted in iatrogenic rupture of both the superficial and profundus flexors. Radiological presentation showed multiple sarcoid involvements in the pulmonary locations and ipsilateral forearm. A diagnosis of sarcoidosis was made based on the presence of non-caseating granulomas with tubercles consisting of Langhans giant cells with lymphocyte infiltration on biopsy, and the patient underwent surgical repair for the contracture. After 2 mo, the patient experienced another spontaneous rupture of the repaired middle finger tendon and underwent surgical re-repair. Satisfactory results were achieved at the 10 mo follow-up after reoperation.
CONCLUSIONS: Sarcoidosis-related finger contractures are rare; thus, caution should be exercised when dealing with such patients to avoid incorrect treatment.
摘要：
背景：结节病是一种多系统疾病，其特征是在各种器官中形成肉芽肿。结节病相关的屈肌腱挛缩在临床上并不常见。这种挛缩与狭窄性腱鞘炎相似，可能导致误诊和误治。在这里，我们报告了一例罕见的结节病相关的手指屈肌腱挛缩，误诊为腱鞘炎。
方法：一名44岁女性患者出现右无名指和中指屈曲挛缩。该患者被误诊为腱鞘炎，并在另一家医院接受了中指A1滑轮的针刀松解术，导致浅表和深屈肌的医源性破裂。放射学表现显示肺部位置和同侧前臂有多个结节病受累。结节病的诊断是基于非干酪样肉芽肿的存在，结节由兰汉斯巨细胞组成，活检时淋巴细胞浸润，患者接受了挛缩的手术修复。2个月后,患者经历了另一次修复的中指肌腱自发断裂,并接受了手术再修复.再次手术后10个月随访取得满意效果。
结论：结节病相关的手指挛缩很少见；因此，与此类患者打交道时应谨慎行事，以避免不正确的治疗。
方法：一名44岁女性患者出现右无名指和中指屈曲挛缩。该患者被误诊为腱鞘炎，并在另一家医院接受了中指A1滑轮的针刀松解术，导致浅表和深屈肌的医源性破裂。放射学表现显示肺部位置和同侧前臂有多个结节病受累。结节病的诊断是基于非干酪样肉芽肿的存在，结节由兰汉斯巨细胞组成，活检时淋巴细胞浸润，患者接受了挛缩的手术修复。2个月后,患者经历了另一次修复的中指肌腱自发断裂,并接受了手术再修复.再次手术后10个月随访取得满意效果。
结论：结节病相关的手指挛缩很少见；因此，与此类患者打交道时应谨慎行事，以避免不正确的治疗。
