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Objective In the patients with calcaneal fractures,the surgical method with intact peroneal tendon sheath was used to treat them,and compared with the traditional surgical method with dynamic retraction of the peroneal tendon,to analyze the influence of the surgical method on the posterior foot movement.Methods A retrospective analysis was made on 60 patients with calcaneal fracture admitted to the Department of Orthopaedics of our hospital from December 2016 to December 2020.The patients were divided into two groups according to the surgical method.The patients in the distraction group received the surgical treatment of traditional dynamic distraction of peroneal tendon(28 cases),and the patients in the preservation group received the surgical treatment of preserving the integrity of peroneal tendon sheath(32 cases).The outcome measures included perioperative indicators,Maryland score of foot function 12 months after surgery,AOFAS score of posterior foot and imaging indicators(Boler Angle and Gissane Angle)12 months after surgery.Results The surgical time(89.34±12.21 minutes)and hospitalization time(5.26±1.47 days)of the retention group were significantly better than those of the traction group[(124.22±11.56)min,(11.59±2.43)d](P＜0.05).At the last follow-up,the AOFAS score(70.56±3.62)and Maryland's excellent and good rate(87.5％)of patients in the retention group were better than those in the traction group(81.37±3.58,71.4％)(P＜0.05).The difference in imaging indicators between the two groups was relatively small(P＞0.05).Conclusion The surgical method of keeping the peroneal tendon sheath intact in the treatment of patients with calcaneal fracture has definite clinical effects,and can also effectively reduce the adverse effects of surgical trauma on posterior foot activity.
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Abstract The authors present a case of fibroma of the tendon sheath with intra-articular location in the knee, more specifically in the infrapatellar fat; with this specific location, this is the fourth case described of an entity that rarely affects large joints. Clinical and epidemiologi-cal aspects, but especially the imaging findings on magnetic resonance imaging scans, are essential for the differential and definitive diagnosis, which was nevertheless established only after a histological study of the excised mass by miniarthrotomy.
Resumo Os autores apresentam um caso de um fibroma da bainha de tendão com localização intra-articular no joelho e origem na gordura infrapatelar. Esta localização específica é extremamente rara, sendo este o quarto caso descrito de uma entidade que raramente afeta grandes articulações. Para o seu diagnóstico aspetos clínicos, epidemiológicos e sobretudo achados imagiológicos da ressonância magnética são fundamentais. Neste caso o diagnóstico definitvo foi apenas estabelecido após estudo histológico da massa excisada por mini-artrotomia.
الموضوعات
Humans , Male , Adult , Patellar Ligament/surgery , Fibroma/diagnostic imaging , Giant Cell Tumor of Tendon Sheath , Knee Injuriesالملخص
Fundamento: el tumor de células gigantes de la vaina tendinosa ocupa el segundo lugar en frecuencia dentro de las neoplasias de la mano. El diagnóstico es clínico y radiológico y se confirma por medios de estudios anatomopatológicos. Objetivo: describir la epidemiología, aspectos clínicos e histológicos del tumor de células gigantes de la vaina tendinosa. Métodos: se realizó un estudio observacional descriptivo para el reporte de seis casos de los archivos del Departamento de Anatomía Patológica de 2016 y 2018, para identificar los casos con diagnóstico tumor de células gigantes de la vaina tendinosa. Resultados: se diagnosticaron un total de seis casos de tumor de células gigantes de la vaina tendinosa, los cuales se correspondieron a igual número de casos para cada sexo, en su mayoría eran pacientes menores de 40 años y en todos los casos el sitio de presentación del tumor fue la mano, con predominio de la región palmar del dedo pulgar. Ninguno de los casos manifestó dolor. En el estudio morfológico microscópico se observaron, los elementos histológicos característicos del tumor de células gigantes de la vaina tendinosa. Conclusiones: los seis pacientes estudiados presentaron la clínica típica del tumor de células gigantes de vaina tendinosa, es decir, refirieron aumento de volumen que se corroboró con el examen físico al palpar una tumoración de tejido subcutáneo, no dolorosa, lisa, blanda y de bordes bien definidos. De igual manera en el estudio histopatológico, se corroboraron los elementos morfológicos característicos, por lo cual se puede establecer que hubo una correlación clínico-patológica del 100 %.
ABSTRACT Background: the giant cell tumor of the tendon sheath occupies the second place in frequency in the neoplasms of the hand. The diagnosis is clinical and radiological, confirmed by anatomic-pathological studies. Objective: to describe the epidemiology, clinical and histological aspects of the giant cell tumor of the tendon sheath. Methods: a descriptive observational study was carried out for the report of six cases from the files of the Department of Pathology from 2016 and 2018, to identify the cases with a diagnosis of giant cell tumor of the tendon sheath. Results: a total of six cases of giant cell tumor of the tendon sheath were diagnosed, corresponding 50% to each sex; the majority were under 40 years old; and in all cases the site of presentation of the tumor was the hand; with a predominance in the palm region of the thumb. None of the cases manifested pain. In the morphological study, the characteristic histological elements of the giant cell tumor of the tendon sheath were observed microscopically. Conclusions: the six patients studied presented the typical symptoms of the Giant cell tumor of the tendon sheath, referring to an increase in volume that was corroborated with the physical examination by palpating a mass of subcutaneous, non-painful, smooth, soft tissue with well-defined borders. In the same way, histopathologically, the characteristic morphological elements were corroborated, for which it can be established that there was a clinical-pathological correlation of 100%.
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Objective To establish the pushing transmission model of tendon-sheath system (TSS) for endoscopic flexible instrument, and study the key influencing factors of transmission efficiency. Methods The force and displacement transmission models of TSS in pushing configuration were built and simulated. The tendon-sheath transmission testing platform was designed to validate the model. The influencing factors, such as transmission velocity, tendon-sheath diameter ratio, curvature radius, were explored using this setup. Results There were obvious nonlinear phenomenon in force and displacement transmission. The model simulation results accorded quite well with the experiment results. Transmission velocity, tendon-sheath diameter ratio, curvature radius all had great effects on pushing force transmission of endoscopic flexible instrument, while they had a smaller effect on displacement transmission. Conclusions The proposed model can be used for calculating pushing force transmission of tendon-sheath system for endoscopic flexible instrument, so as to provide the doctors with force feedback at the tip of the end effector, and ensure the safe operation and improve the surgical effects. For better design and control of endoscopic flexible instrument, the transmission velocity, tendon-sheath diameter ratio, curvature radius must be comprehensively considered.
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ABSTRACT: A 12-year-old female mixed-breed dog presented with lameness, pain, and an enlarged, non-ulcerated, nodular mass in the region proximal to the tarsal joint of the right pelvic limb. Surgical excision was performed, revealing a 6.5 cm mass adherent to the deep flexor tendon and adjacent tissues. The cut section had cysts filled with blackened clotted material, which exuded reddish serous fluid. Microscopically, the cysts were filled with red blood cells and were either denuded or covered by synoviocytes. In addition, the mass was characterized by marked fibrovascular connective tissue associated with siderophages and multinucleated giant cells. These findings were consistent with those of pigmented villonodular tenosynovitis, a rare condition affecting several animal species and humans.
RESUMO: Uma cadela de 12 anos, sem raça definida, apresentou claudicação, algia e aumento de volume não ulcerado, de aspecto nodular, na região proximal à articulação do tarso do membro pélvico direito. A excisão cirúrgica foi optada e revelou uma massa de 6,5 cm de diâmetro, aderida ao tendão flexor profundo e aos tecidos adjacentes. Ao corte, exsudava líquido seroso avermelhado e cistos preenchidos por material coagulado enegrecido foram observados. Microscopicamente, a massa apresentava formações císticas frequentemente preenchidas por hemácias, que encontravam-se ora revestidas por sinoviócitos, ora desnudas. Havia ainda acentuada quantidade de tecido fibrovascular associado a siderófagos e células gigantes multinucleadas. Esses achados foram consistentes com tenossinovite vilonodular pigmentada, uma rara condição que afeta diversas espécies de animais e humanos.
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BACKGROUND: Calcaneal fracture is the most common patella fracture. Traditionally, surgical treatment via an enlarged lateral approach is the gold standard method for the treatment of calcaneal fractures. However, this method can lead to joint stiffness and peroneal tendon adhesion to different extents, resulting in postoperative foot pain. OBJECTIVE: To investigate the effect of preserving the integrity of peroneal tendon sheath on hindfoot movement during open reduction and internal fixation of calcaneus fractures. METHODS: A total of 160 patients with displaced intra-articular calcaneus fractures who were admitted to the Department of Foot and Ankle Surgery, Affiliated Hospital of Binzhou Medical University from July 2016 to September 2017 were randomly divided into a control group and an experimental group. The classical lateral “L” incision was used in both groups. In the control group, the calcaneus was exposed by traditional dynamic retraction of the fibular tendon, while the experimental group was treated by static retraction with the preservation of fibular tendon sheath. The trial protocol was approved by the Ethics Committee of the Affiliated Hospital of Binzhou Medical University on February 18, 2016 with the approval No. 2016-G026-01. RESULTS AND CONCLUSION: There were 156 patients with complete follow-up data, 78 in the control group and 78 in the experimental group. The visual analogue scale scores on the first day, Bohler angle and Gissane angle at the 3rd month, and ankle dorsiflexion and plantar flexion angle at the 6th month of internal fixation were similar in the two groups. Hind foot valgus and varus angles at the 6th month of internal fixation and the American Orthopedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale scores at the 1st year of internal fixation in the experimental group were better than those in the control group. Meanwhile, the excellent and good rate of Maryland hindfoot scoring system in the experimental group was higher than that in the control group at the last follow-up. There were four cases of incision complications in the control group (one case of infection and three cases of necrosis) and two cases of necrosis in the experimental group. These findings indicate that calcaneus fracture surgery with preserving the integrity of peroneal tendon sheath can significantly improve the mobility of the hindfoot, and improve the patient’s satisfaction, and meanwhile do not increase the incidence of incision complications.
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Lipoma arborescens or synovial lipomatosis is a rare disorder that is characterized by mature fat infiltration of the hypertrophic synovial villi, most frequently affecting the supra-patellar pouch of the knee. This paper presents a case of lipoma arborescens of the ankle joint bilaterally in an adult patient with involvement of both the intra-articular synovium and the synovial sheath of the tendons around the ankle.
الموضوعات
Adult , Humans , Ankle Joint , Ankle , Knee , Lipoma , Lipomatosis , Magnetic Resonance Imaging , Synovial Membrane , Tendonsالملخص
Objective To investigate the MRI characteristics and pathological features of giant cell tumor of the tendon sheath (GCTTS)to improve the diagnostic accuracy.Methods MRI features of 22 cases of GCTTS confirmed by postoperative pathology were reviewed retrospectively.MRI plain scans were performed in all patients,in which there were 16 cases with enhanced MRI scans.HE staining and immunohistochemical analysis were used to investigate the histopathological characteristics.Results All of lesions were unilateral,3 cases were located in the left ankle,2 cases in the right ankle,5 cases in the left hand,2 cases in the right hand,2 cases in the left knee joint,6 cases in the right knee joint,1 case in the left foot and 1 case in the right foot.There were 14 cases of local type giant cell tumor of the tendon sheath(L-GCTTS)and 8 cases of diffuse type giant cell tumor of the tendon sheath(D-GCTTS). Compared with normal skeletal muscle signals,lesions showed isointensity on T1WI and high-low mixed intensity on T2WI.No bone abnormality was found in 11 cases,adjacent bone absorption in 6 cases,and adjacent bone destruction in 5 cases.In 16 patients with contrast-enhanced MRI,significantly heterogeneous enhancement was showed in 11 cases,mild heterogeneous enhancement in 3 cases and no heterogeneous enhancement in 2 cases.Pathological results revealed that GCTTS parenchyma cells were mainly formed by multinucleated giant cells and mononuclear stromal cells,scattered with interstitial collagen fibers and different amounts of hemosiderin composition.Conclusion MRI has a significant advantage in detecting hemosiderin in GCTTS.Combination of the history with location, GCTTS may be diagnosed by pathological examination.
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The presented study aimed to assess objectively the response of distal interphalangeal joint (DIJ), navicular bursa (NB) and deep digital flexor tendon sheath (DDFTS) anesthesia in horses with forelimb hoof lameness; and evaluate if the presence of radiographic abnormalities on navicular bone could interfere on blocks' results. Fifteen horses with lameness improvement above 70% after palmar digital nerve (PDN) block were selected for this study. Blocks were assessed separately on five consecutive trials at seven different time-points. The fifth trial was performed to evaluate the influence of exercise on preexisting lameness. Most of horses (73.33%) presented pain related to the podotrochlear apparatus based on clinical and lameness exam and blocks' responses. NB and DIJ anesthesia differed on the frequency of horses with lameness improvement above 70% only at 10min (p=0.03), and both differed from DDFTS block until 30'(p<0.05). The blocks' response was variable along the time and the highest means for NB, DIJ and DDFTS were observed at 5-10 minutes ('), 15-20' and 10-15' respectively.Exercise had low interference on lameness intensity since no improvement above 50% was observed and an increase on lameness intensity over time was identified in seven horses. Variable grades of navicular bone radiographic lesions were observed in 14 horses, although these lesions had no interference on blocks' response (p>0.05). The NB and DIJ blocks had similar responses and both were superior to DDFTS anesthesia, coincident with a major prevalence of podotroclear apparatus abnormalities in this equine population.(AU)
O presente estudo avaliou, de forma objetiva, as respostas do bloqueio da articulação interfalangeana distal (AID), da bursa do navicular (BN) e da bainha do tendão flexor digital profundo (BTFDP) em equinos com claudicação ligada ao casco nos membros torácicos; além de analisar a influência das alterações radiográficas do osso navicular no resultado dos bloqueios. Quinze cavalos, que apresentaram uma melhora da claudicação acima de 70% após o bloqueio do nervo digital palmar, foram selecionados para este estudo. Os bloqueios foram avaliados separadamente em cinco turnos consecutivos e em sete tempos diferentes. O quinto turno foi utilizado para analisar a influência do exercício sobre a claudicação preexistente. A maioria dos cavalos (73,33%) apresentou dor relacionada à porção palmar do casco, com base nos achados do exame clínico em movimento e nas respostas dos bloqueios. As anestesias da BN e da AID apresentaram diferença quanto à frequência de cavalos com melhora da claudicação acima de 70% apenas aos 10min (p=0.03), e ambos diferiram do bloqueio da BTFDP até os 30min (p<0.05). A resposta dos bloqueios foi variada ao longo do tempo, e as maiores médias de melhora da claudicação para os bloqueios BN, AID e BTFDP foram observadas aos 5-10min, 15-20min e 10-15min, respectivamente. O exercício teve pequena interferência na intensidade da claudicação, uma vez que nenhuma melhora acima de 50% foi observada e sete cavalos aumentaram a intensidade da claudicação ao longo do tempo. A presença de diferentes graus de lesão radiográfica do osso navicular foi observada em 14 cavalos, porém essas lesões não interferiram na resposta dos bloqueios (p>0,05). Os bloqueios da BN e da AID apresentaram respostas semelhantes, e ambos foram superiores ao bloqueio da BTFDP, coincidindo com uma marcada prevalência de doença do aparato podotroclear nesta população de equinos.(AU)
الموضوعات
Animals , Anesthetics, Local/analysis , Finger Joint/pathology , Horses , Lameness, Animal/drug therapy , Hoof and Claw/pathology , Osteoarthritis/veterinaryالملخص
Pacinian corpuscle-like structures were identified in the digital tendon sheaths and nail beds of hands obtained from eight of 12 human fetuses of gestational age 20–34 weeks (crown-rump length, 150–290 mm). The aberrant corpuscles were present in tight fibrous tissue connecting the flexor tendon sheath to the dorsal aponeurosis (138 corpuscles in the thumbs and all fingers of eight fetuses); loose fibrous tissue inside the sheath on the dorsal side of the tendon (37 corpuscles in the thumbs and all fingers of four fetuses); and the nail bed (10 clusters in the thumbs and second fingers of four smaller fetuses). The aberrant corpuscles in the tendon sheath were classified into two types: thin and short, with tightly packed lamellae, of diameter 20–40 µm and length 20–200 µm; and thick and long, with loosely packed lamellae, of diameter 70–150 µm and length 0.5–1.5 mm. The small corpuscles tended to form clusters, each containing 5–10 structures. Their similarity indicated that the tight and loose lamellae in these two types of corpuscles corresponded to typical immature and mature corpuscles, respectively, usually distributed along the palmar digital nerve. However, mature, large corpuscles were absent from the nail bed, and most aberrant corpuscles were smaller than typical corpuscles along the nerve. The aberrant corpuscles were apparently incorporated into the tendon sheath or nail bed during fetal vascular development, but they appeared to degenerate after birth due to mechanical stress from the tendon or nail.
الموضوعات
Humans , Fetus , Fingers , Gestational Age , Hand , Parturition , Stress, Mechanical , Tendons , Thumbالملخص
A case diagnosed as diffuse giant cell tumor of tendon sheath with chondroid metaplasia in right temporomandibular joint was reported. The clinicopathological features, diagnosis, and treatment were discussed with the literature review.
الموضوعات
Humans , Giant Cell Tumor of Tendon Sheath , Metaplasia , Temporomandibular Jointالملخص
Objective To study MRI features of fibroma of tendon sheath(FTS)and giant cell tumor of tendon sheath(GCTTS), so as to improve the diagnosis and differential diagnosis of two lesions. Methods Seventeen patients with FTS and 27 patients with GCTTS confirmed by operation and pathology were retrospectively analyzed. All patients were examined with MRI. The location, size, shape and the relationship with the surrounding tissue, the signal feature and enhancing pattern of the two groups were compared. Imaging features in the two groups were assessed and analyzed by using independent samples t test and Chi-square test. Results FTS were nodular or mass-like lesions(n=11). Few lesions appeared adjacent bone absorption(n=2). On T2WI, the lesions showed peripheral low signal ring(n=6)or internal mixed low-signal intensity of was striped or filamentous configurations(n=10). The volume of low-signal intensity accounted for more than 2/3 of the total lesion's volume(n=6). Enhanced T1WI, tumors revealed ring enhancement(n=6). GCTTS appeared mostly lobulated(n=16), common with adjacent bone compressive absorption(n=9). On T2WI, most of lesion had a peripheral low signal ring(n=22). Tumors revealed mixed high signals intensity with granular or patchy irregular low signal intensity scattered in the mass(n=17), the area of low signal accounts for less than 1/3 of total neoplastic volume(n=18). On contrast T1WI, GCTTS appeared heterogenous enhancement. Statistical analysis showed that the shape of the lesion, the presence or absence of compressive bone absorption, the presence of a low signal ring around the lesion, the shape of the Low-signal in T2WI and the proportion, and the presence of circumferential enhancement(P0.05). Conclusion FTS and GCTTS has a different characteristic of MRI features. FTS were nodular or mass-like, T2WI signal was mixed low, the shape of the low-signal was striped or filamentous, accounting for more than 1/3 of total lesion's volume, enhanced T1WI, tumor shows ring enhancement;GCTTS appears mostly lobulated.Most of lesion has low signal ring, common with adjacent bone compress compressive absorption. T2WI, tumor reveals mixed high signals intensity with granular or patchy irregular low signal intensity scattered in the mass. The area of low signal accounts for less than 1/3 of total neoplastic volume.
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OBJETIVO: Mostrar los hallazgos imagenológicos en la resonancia magnética (RM) de la sinovitis vellonodular pigmentada (SVP) y el tumor de células gigantes de la vaina sinovial (TCGVS), dado que son entidades que representan un diverso grupo de alteraciones en la proliferación de la sinovial. MATERIALES Y MÉTODOS: Entre mayo de 2011 y junio de 2013, se estudiaron en nuestra institución 25 casos con diagnóstico histológico de proliferación de la sinovial. Se destacaron los distintos tipos de presentación en imágenes a través de una RM 1.5 Tesla. Los resultados fueron analizados y comparados con la literatura. RESULTADOS: La RM mostró características similares para esta patología en todos los pacientes. No obstante, se distinguieron 4 patrones principales de presentación, dependiendo de la morfología, la localización de la lesión y las características radiológicas diferenciales. Estos fueron: como dominante, el tumor de células gigantes de la vaina sinovial (n = 10), todos de localización extraarticular; la sinovitis vellonodular pigmentada de localización bursal (n = 2); la sinovitis vellonodular pigmentada de forma intraarticular focal (n = 5); y la sinovitis vellonodular pigmentada difusa (n = 8). CONCLUSIÓN: La sinovitis vellonodular pigmentada y el tumor de células gigantes de la vaina sinovial se consideran entidades similares desde el punto de vista anatomopatológico. La RM fue de gran utilidad para objetivar tanto las características radiológicas comunes como las diferenciales. Estas últimas, junto con la localización, nos permitieron clasificar 4 patrones de presentación. Su reconocimiento posibilita un adecuado seguimiento de la patología y un óptimo manejo terapéutico.
PURPOSE: To show the resonance magnetic imaging (MRI) findings of pigmented villonodular synovitis (PVNS) and giant cell tumor of the tendon sheath (PVNTS), entities with similar histology but differences in clinical and some radiological manifestations. MATERIALS AND METHODS: We studied 25 cases with histologically benign synovial proliferation in intra and extraarticular location of the extremities. It highlighted with a 1.5T MRI unit the different types of images presentation. The results were analyzed and compared with the literature. RESULTS: MRI displayed very specific imaging features in all patients. However, we were able to distinguish 4 main patterns of presentation depending on the morphology, location of the lesion and radiological differential. These were: as dominant presentation, pigmented villonodular synovitis localized form (n=10); pigmented villonodular synovitis bursal form (n=2); pigmented villonodular synovitis focal (n =5); and pigmented villonodular synovitis diffuse (n = 8). CONCLUSION: Both pigmented villonodular synovitis as well as giant cell tumor of the tendon sheath are considered similar from the point of view of the histological findings. MRI was useful to objectify both radiological features in common, such as the differential, which along with the location, allow us to classify patterns into 4 individual presentations. This recognition involves adequate radiological evaluation and is important for optimal management.
الموضوعات
Humans , Male , Female , Adult , Aged , Synovitis, Pigmented Villonodular , Magnetic Resonance Spectroscopy , Synoviocytes , Giant Cell Tumor of Tendon Sheath , Giant Cell Tumors , Pain , Magnetic Resonance Imaging , Foot , Hand , Kneeالملخص
Iliotibial band (ITB) friction syndrome is a common overuse injury typically seen in the active athlete population. A nodular lesion on the inner side of the ITB as an etiology or an accompanying lesion from friction syndrome has been rarely reported. A 45-year-old male presented with recurrent pain and a movable nodule at the lateral joint area, diagnosed as ITB friction syndrome. The nodule was confirmed as a rare intra-articular fibroma of the tendon sheath (FTS) on the basis of histopathologic findings. We describe the MRI findings, arthroscopic and pathologic features, in this case of intra-articular FTS presenting with ITB friction syndrome.
الموضوعات
Humans , Male , Middle Aged , Cumulative Trauma Disorders/complications , Fibroma/etiology , Friction , Iliotibial Band Syndrome/complications , Knee Joint/pathology , Magnetic Resonance Imaging , Pain/etiology , Tendons/pathologyالملخص
Objective To explore the imaging features and its correlation with pathological findings of giant cell tumor of the ten-don sheath (GCTTS).Methods The clinical data,radiographic images and pathological characteristics of sixteen cases of GCTTS confirmed by pathology were retrospectively reviewed.Plain CT,pre and post-contrast MR were performed in all patients.HE stai-ning was used to investigate the histological characteristics of GCTTS,and immunohistochemistry was employed to detect the ex-pression of CD68.Results There were nine cases of local type GCTTS and seven cases of diffuse type GCTTS in our present study. Nine cases were located in the knee joint,four cases in the foot,and three cases in the hand.Compared with normal skeletal muscle signals,lesions showed isointensity or low intensity on T1 WI and inhomogeneous low intensity on T2 WI.Three cases caused adja-cent bone destruction,one case lead to adjacent bone absorption,and no abnormality was found in other twelve cases.Six cases were injected Gd-DTPA for enhanced scan,in which four cases showed significantly heterogeneous enhancement,one case mild heteroge-neous enhancement,and one case no heterogeneous enhancement.Pathology examination results revealed that GCTTS parenchyma cells were mainly formed by histocyte-like monocytes,and scattered multinuclear giant cells.GCTTS mesenchyme was rich in gelat-inous fiber and hemosiderin pigmentation.Conclusion MR has a significant advantage in detecting specific hemosiderin pigmentation and determining lesions area of GCTTS.Combination of MR with pathology results may improve the diagnosis accuracy.
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Ganglion cysts are tumor-like lesions in the soft tissues, generated by mucoid degeneration of the joint capsule, tendon or tendon sheaths on the dorsum of hand, wrist and foot. However, an intratendinous origin for a ganglion cyst is extremely rare. During dissection of the popliteal fossa, a cyst of 2.5 cmx2 cmx0.5 cm was observed in the tendon of right semimembranosus, 3.5 cm above the insertion of the muscle. Contrast X-ray revealed the cyst as not communicating with the knee joint or any adjacent bursae. Histopathological examination confirmed the diagnosis of ganglion cyst.
الموضوعات
Diagnosis , Foot , Ganglion Cysts , Hand , Joint Capsule , Knee , Knee Joint , Tendons , Wristالملخص
Localized tenosynovial giant cell tumor (TGCT) usually occurs in the hand and foot regions. However, localized TGCT with extensive cartilaginous metaplasia is rare, especially in the tendon sheath of the toe. Here, we report a case of localized TGCT with cartilaginous metaplasia in a 57-year-old man. The tumor presented as a lobular mass measuring 2.2 cm in its greatest dimension and arose in the flexor digitorum tendon sheath of the right 2nd toe. Clinically, the mass was palpable 1 year ago and brought pain during walking. Microscopically, the mass was composed of focal conventional TGCT and cartilaginous components. The conventional TGCT areas consisted of mononuclear cells, multinucleated giant cells, and hemosiderin deposition. The chondroid areas were extensive and comprised more than 90% of the whole tumor. In this case, the mononuclear cells in the conventional TGCT areas showed focal immunohistochemical staining for podoplanin and S100 protein as well as diffuse staining for CD68, which is consistent with the staining pattern of conventional TGCT. The mononuclear cells in the chondroid areas were focal positive for podoplanin and diffuse positive for S100 protein. Chondroid metaplasia in diffuse TGCT has been reported in 10 cases involving the temporomandibular, elbow, and hip joints. However, there has been no report of a localized form of chondroid TGCT involving an extra-articular region.
الموضوعات
Humans , Middle Aged , Elbow , Foot , Giant Cell Tumors , Giant Cells , Hand , Hemosiderin , Hip Joint , Metaplasia , Staphylococcal Protein A , Tendons , Toes , Walkingالملخص
Hemangioma is a common tumor which can occur in any part of the body. It can develop in any area the hand. Hemangioma of the hand usually presents with swelling, pressure pain, accompanied by motion restriction. Rarely it has throbbing pain. We report the case of a 21-year-old woman who had a hemangioma of flexor digitorum superficialis tendon sheath in second finger with restriction of motion and were treated by surgical intervention.
الموضوعات
Female , Humans , Young Adult , Fingers , Hand , Hemangioma , Tendonsالملخص
Fibroma of the tendon sheath is an uncommon soft tissue tumor presenting as a solitary, slow-growing, firm, painless, small nodule, which shows strong attachment to the tendon or tendon sheath. It is usually localized on fingers and hand tendons in adults between the age of 20 and 40 years old. This case concerns a 61-year-old man presenting with a 5-year history of multiple cutaneous nodules on both palms and soles. Skin biopsy confirmed fibroma of the tendon sheath. Blood tests showed a high titer of rheumatoid factor and positivity to anti-nuclear antibody. No case of fibroma of the tendon sheath occurring multifocally on both palms and soles has been previously reported. Herein, we report on a very rare case of multiple fibromas of the tendon sheath arising from palms and soles, which supports the pathogenetic hypothesis that this tumor may be a reactive process rather than a true neoplasm.