Unusual Locked Trigger Finger Due to Tophaceous Infiltration of Wrist Flexor Tendon
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2017, Vol 1, Issue 7
Abstract
Tophi can present as a first sign of hyperuricemia but reports on the involvement of the flexor tendons of the hand is rare. Although tuberculous tenosynovitis is a more common etiology for swelling over the wrist, gout must be among the differentials irrespective of hyperuricemic status. Because of its low frequency, gouty involvement of the flexor tendons is not often considered in the differential diagnosis of tenosynovitis. We report a rare case in which intratendinous tophaceous gout was found within the flexor digitorumsuperficialis tendon at the wrist causing patient to have trigger finger like symptoms.Gout is an inflammatory arthritis caused by cellular deposition of monosodium urate crystal [1]. Tophi are chalky, gritty accumulations of monosodium urate crystals that build up in soft tissue in an untreated gouty joint [1]. The peak incidence of gout is between the ages of 30-50 with the prevalence increasing with age [1]. Gout is five times more common in men [1]. Tophi can present as a first sign of hyperuricemia but reports on the involvement of the flexor tendons of the hand is rare [2]. Although tuberculous tenosynovitis is a more common etiology for swelling over the wrist, gout must be among the differentials irrespective of hyperuricemic status. It can present clinically as tendon rupture, nerve compression, or digital stiffness and can be complicated with infection1. Because of its low frequency, gouty involvement of the flexor tendons is not often considered in the differential diagnosis of tenosynovitis [2]. We report a rare case in which intratendinoustophaceous gout was found within the flexor digitorum superficialis tendon at the wrist causing patient to have trigger finger like symptoms.
Authors and Affiliations
William Hau Wuei Huang, Juzaily Fekry Leong, Shalimar Abdullah
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