Tenosynovectomy in Rheumatoid Tenosynovitis

概要

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Tenosynovitis is very common in rheumatoid arthritis. It has been said, particularly in previous literatures that over half of all patients with rheumatoid arthritis have tendon disease. The extensor tendons are frequently involved, but tenosynovitis of the flexor tendons is often not diagnosed. In a consecutive series of 243 patients attending three hospitals, the cases suffering from rheumatoid tenosynovitis comprised 79 hands.The incidence was 2.5 times higher in the flexor tendons of the hand than in the extensor tendons. There were lesions in the extensor tendons in 26 hands with rupture as a result in 6, and most of them were caused by so-called "Caput ulnae syndrome", in which the caput ulnae forms a prominent lump on the dorsal aspect of the wrist.As for flexor tenosynovitis, we often palpated the nodules at the level of the metacarpophaangeal joint of the fingers, associated with "Snapping" or "Locking" at flexion.We have operated 18 cases with rheumatoid tenosynovitis, including 2 cases by procedure of tendon transfer to ruptured extensors.The purpose of this paper is to introduce some cases, and to emphasize usefulness of early synovectomy in the tendon and the tendon sheath.
西日本整形・災害外科学会の論文