palm thorn synovitis

Clipboard, Search History, and several other advanced features are temporarily unavailable. Contact us if you experience any difficulty logging in. Some society journals require you to create a personal profile, then activate your society account, You are adding the following journals to your email alerts, Did you struggle to get access to this article? You need to be watchful. We have reviewed seven cases of synovitis caused by date palm thorns, six involving the knee and one the ankle. BibTex; Full citation; Abstract. Nine weeks postinjury from plant thorn puncture injury. 2007 May;26(5):849-51. doi: 10.1007/s10067-006-0482-0. Date palm thorn synovitis. Historically, it is considered aseptic and treated with removal of the intraarticular foreign body and affected synovial lining. Clin Orthop 1963; 30: 188–93. Tendon sheath inflammation is typically the result of injury to the tendon or surrounding muscle or bone. Simply select your manager software from the list below and click on download. Hegde Medical … Injuries in which palm thorns become embedded in soft tissues or cartilage, leaving no external evidence of their presence, sometimes present a baffling diagnostic problem. This product could help you, Accessing resources off campus can be a challenge. Br J Radiol 44:642-645, 1971 6. Vaishya R. A thorny problem: the diagnosis and treatment of acacia thorn injuries. Figure 6. By continuing to browse Carandell M, Roig D, Benasco C (1980) Plant thorn synovitis. NIH 2:175 – 179. Inasmuch as the palm thorn will be found in only a single joint, diseases which affect multiple joints, such as rheumatoid arthritis, bacteremia, allergic arthritis and Clutton's joints, are easily excluded. An ultrasound examination revealed a foreign body in the posterior lateral aspect of the right knee. And wear eye protection! Nine weeks postinjury, the patient’s symptoms had worsened, and the persistent inflammation and discomfort of the left long finger PIP joint now concurrently presented with increased joint stiffness on examination (Figure 2). Thorn Synovitis Magazines, Thorn Synovitis eBooks, Thorn Synovitis Publications, Thorn Synovitis Publishers Description: Read interactive Thorn Synovitis publications at FlipHTML5, download Thorn Synovitis PDF documents for free. the palm of abo ut 10-y ear dur ati on. Figure 3. Ramanathan EB, et al. This is reflected by the multiple cases where patients were initially misdiagnosed with conditions like septic arthritis.10 This may especially be the case if the patient does not recall the initial thorn injury. Laboratory results only act to confirm an inflammatory process, often revealing an elevated erythrocyte sedimentation rate, white blood cells, and C-reactive protein.6 Due to the often small size of retained plant thorn fragments and their radiolucent nature, diagnostic imaging such as radiography and ultrasonography have been used with varying degrees of success.5,7 As a result, plant thorns often escape detection as a foreign body.1,3,8,9 Here, we present a case of plant thorn synovitis of the hand in addition to a review of the current literature surrounding plant thorn synovitis in the hands. This retrospective clinical study compares the results of extensive versus limited synovectomy at the time of palm thorn removal from a joint space. I was planting a sago palm today and wore gloves but think the top of my left hand got pricked by the plant. Cahill N, King JD. I took the thorn out and four hours later my finger started throbbing and turned red with the swelling from plant thorn synovitis. Login failed. The tendon was reapproximated and the wound closed after tourniquet deflation and haemostasis. You can be signed in via any or all of the methods shown below at the same time. Following the injury, the patient had presented to a community hospital emergency department, where large thorn splinters were removed from the skin. With the suspicion of septic arthritis, the patient was treated with antibiotics on repeated occasions, two negative joint aspirations and a knee joint exploration were performed. Due to the unfamiliarity with the diagnosis of plant thorn arthritis and the relatively superficial location of the foreign material, it was anticipated that the tiny foreign bodies would likely resolve spontaneously. The clinical presentation was that of an acute synovitis of 2 months' duration, that improved quickly after arthroscopy for biopsy, and articular washout. Another interesting question this review raises is why plant thorn synovitis is so uncommonly seen. Her symptoms were not improved by antibiotic use and the patient described joint stiffness and pain in the morning. Get the latest public health information from CDC: https://www.coronavirus.gov, Get the latest research information from NIH: https://www.nih.gov/coronavirus, Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. Seven cases of PTS were identified at our institution from January 1979 to July 1990, six of whom were men. USA.gov. Sperber AD, et al. All 6 relevant studies were case reports. Five were satisfactorily treated by thorough irrigation of the joint with normal saline, but two required arthrotomy and synovectomy. Infectious causes such as septic arthritis and cellulitis were the most common initial diagnoses.10-12 In the diagnosis of a plant thorn as a foreign body, X-ray imaging was found to be ineffective in visualizing thorn fragments, while some cases reported visualization of fragments with ultrasound imaging (Table 3).10-15, Each reviewed case report of plant thorn synovitis ultimately underwent treatment with surgical exploration, removal of foreign material, and synovectomy if the synovium was shown to be compromised. New Emirates Medical Journal Journal Country: … When they are promptly identified and treated, a good result can be expected without further complications. Figure 1. FundingThe author(s) received no financial support for the research, authorship, and/or publication of this article. Ages of patients with published reports of plant thorn synovitis involving the hands ranged from 7 to 58 years, with a median age of 24.5 years. Inaoui, R, Bertin, P, Preux, P-M, Trèves, R. View or download all content the institution has subscribed to. Find out about Lean Library here, If you have access to journal via a society or associations, read the instructions below. Due to the refractory response to antibiotic and anti-inflammatory treatments, a suspicion for plant thorn arthritis arose following a literature review. Because of this, patients with undiagnosed plant thorn synovitis can progress to develop chronic arthritis.5,16 The annual incidence of undifferentiated arthritis has been shown to range from 41 to 149 per 100 000 adults, comprising approximately 30% of all inflammatory arthritis.18 As high as 50% of these chronic undifferentiated arthropathies do not achieve resolution in symptoms or diagnosis.19 With these numbers in mind, it is important to consider that a subset of undifferentiated chronic arthropathies may be attributable to plant thorn arthritis. Cahill N, King JD. Thorn pricks. J Pediatr Orthop1984;4:175–9. The patient began hand therapy to range the affected finger at 4 weeks postoperatively. However, the significance of this is limited by the small sample size of this review. The patient did well postoperatively, only to have the joint effusion recur 1 month later. This can come… Palm thorn injury to tendons and joints is characterized in most patients by an acute inflammatory stage followed by a relatively asymptomatic period and finally by chronic synovitis or tenosynovitis. Please read and accept the terms and conditions and check the box to generate a sharing link. 1977 Jul-Aug; 20 (6):1206–1212. Both were imm but the boy said that some thorn remnants were still We report a 57-year-old healthy … A magnetic resonance imaging examination was initially requested to exclude septic arthritis, and demonstrated a joint effusion, synovitis, and a 2-cm linear opacity embedded in the synovium. 4. What plants cause plant thorn arthritis? In a nonindustrial accident in 1973, a 2-year-old girl was killed and her aunt injured when they were struck by a hail of 57 coconuts falling from palm trees on Waikiki Beach, Hawaii.1 Secondary infection is common around traumatically implanted thorns, needles, or spines. Of interest, our case was able to visualize the fragments on both occasions. (a) T1w sequen ce show s a low-sig nal, smoo th, w ell-cir cum scr ibed subc u tane ou s les ion sup erf icia l to the. Cahill N, King JD: Palm thorn synovitis. When the inflammatory response occurs adjacent to or within a joint, the patient develops signs and symptoms consistent with a typical inflammatory arthritis including erythema, joint swelling, warmth, and limited range of motion.3-5 As the granulomatous response is localized to the injured joint, plant thorn synovitis typically presents as a monoarthritic disease.4 To date, thorns from multiple plant species have been implicated in cases of synovitis and it is unclear if there are different risks associated with different plant species.2, Due to its rarity, the knowledge surrounding plant thorn synovitis is limited to what is described in reported cases. Arthritis Rheum. I cut it down the next day. 3 Kelly JJ. 1. Misdiagnosis, Palm thorn, Synovectomy, limited and extensive, Synovitis. For the purpose of surgical planning, a repeat ultrasound was taken and skin markings were made overlying the visualized foreign bodies by radiology (Figure 2). J Bone Joint Surg1966;48-B:474–7. 5. By Taşkiran E. and Toros T. Cite . Palm thorn synovitis. Plant-thorn synovitis is a rare cause of arthritis from a plant thorn penetrating a joint. This site needs JavaScript to work properly. KARSHNER RG, HANAFEE W. Palm thorns as a cause of joint effusion in children. Maylahn DJ: Thorn-induced tumors of the bone. Arthritis Rheum1977;20:1125–8. Palm thorn synovitis. NUJHS Vol. 1994 Dec;33(12):1190-1. HHS One may suspect an underlying palm thorn in the presence of prolonged joint swelling and a lack of response to antibiotics. I was stuck with a palm frond while assisting a coworker who was trimming the palm branches. [Synovitis J Pediatr Orthop. The involved plant thorns species included Zanthoxylum ailanthoides, prickler bush, locust thorn, rose thorn, blackthorn, and cockspurn thorn1-6 (Table 3). Many years ago I was knocking coconuts off a tree w/a shovel when one rolled down and hit me on the head. Plant Thorn Synovitis: An Uncommon Cause of Monoarthritis By Thomas P. Olenginski, David C. Bush, and Thomas M. Harrington Plant thorn synovitis (PTS) is an uncommon cause of monoarthritis. Other limitations of this study include the exclusivity of available literature to case reports and case series. Ned Cahill;John King; + Author Information : Checking for direct PDF access through Ovid: Abstract Summary This retrospective clinical study compares the results of extensive versus limited synovectomy at the time of palm thorn removal from a joint space. Epub 2006 Sep 12. [Google Scholar] Borgia CA. Interestingly, including our patient, 2 (25%) of 8 reported cases of plant thorn arthritis in the hands involved a patient with a history of psoriasis. Histopathology demonstrated a granulomatous synovitis. Flow diagram of study selection. Olenginski, TP, Bush, DC, Harrington, TM. For more information view the SAGE Journals Sharing page. A branch with a 10 inch thorn fell down unexpectedly and the thorn pierced my right middle finger. The patient developed cellulitis following the removal and had been taking cephalexin orally for 2 weeks at the time of her consultation. A week later I went to the emergency room (ER) and was mistakenly diagnosed with a bacterial infection. Despite the antibiotic treatment, the patient reported persistent pain and decreased flexion in the left long finger PIP joint. 2 Karshner AG, Hanafee W. Palm thorns as a cause of joint effusion in children. This dilemma takes place Whilst a thorn towards a plant enters a joint as a result of puncturing it. 2007 Jun;15(6):758-60. doi: 10.1007/s00167-006-0197-4. We believe the severity of symptoms may be attributed to the type of thorn and the amount of thorn material in the periarticular tissues. Figure 5. J Pediatr Orthop1984;4:175–9. Pantoea agglomerans was identified in the synovial fluid . DATE PALM THORN SYNOVITIS 513 VOL.72-B,No.3.MAY1990 Non-specific synovitis inacaseofdate palm thorn injury (haematoxylin andeosin). The diagnosis is challenging and is often made on the basis of exclusion.16 As plant thorn synovitis is an inflammatory response to retained fragments of plant thorns, it commonly progresses to arthritis due to inflammatory damage of periarticular structures.16 Undiagnosed, it can evolve into an undifferentiated chronic arthritis.6 However, this form of arthritis is unique in its potential for full recovery following a synovectomy, which is understood to be the only definitive treatment.10,11,16 Our experience with this reported case reflects the diagnostic challenges and emphasizes the importance of a surgical approach in the diagnosis and treatment of this rare form of arthritis. Table 1 outlines the demographics from the Scandinavian coun- tries all the content the society has access to statement informed... Outlines the demographics from the radiolucent non-metallic FBs ear dur ati on presented with recurrent arthritis of the knee of. L. 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Thorn yourself, fragments may remain under your skin aromatic plant distributed in East Asia, used! Advantages, surgical exploration with excision of plant thorn synovitis plant distributed in East Asia, frequently! We, Babcock, DS, Wilson, JL, Burch, RA healthy … palm. And commonly overlooked cause of joint effusion in children information for this article with your and. Can come… i was stuck with a 10 inch thorn fell down unexpectedly and the pierced. Later i went to the hand who was trimming the palm of abo ut 10-y ear dur ati on foreign! Joint aspirate the discovery of a foreign body giant cell reaction andeosin.! The microscope, an aromatic plant distributed in East Asia, is used as a cause of effusion. 3Rd, Goldberg L. Local and systemic reactions to puncture injuries by the limited literature, plant is. Extracted from the level of the institution box to generate a Sharing link inside and out of knee. And … palm thorn: an unusual case of plant thorn synovitis an exploratory surgery was out. Were related to plant thorns is a valuable tool for the research, authorship, and/or publication this. Normal limits, and Outcome of reported cases of PTS were identified at institution. Boy fell against a blackthorn bus1 and noted that two thorns had pe his! Cases of plant thorn synovitis 3rd, Goldberg L. Local and systemic reactions to puncture injuries by the plant thorns..., Roig D, Benasco C ( 1980 ) plant thorn synovitis lateral aspect of the biopsy a! Case Rep. 2016 Jul-Aug ; 6 ( 3 ) images of the shown. Weeks postoperatively extensor mechanism the biopsy showed a granulomatous synovitis with vegetable tissue identified as a cause joint. Has access to Journal via a society or associations, read the instructions below aspect of the investigations inconclusive... Severity of symptoms ; patients who underwent limited synovectomy required subsequent extensive synovectomy and noted that two thorns pe... Out about Lean Library here, if you remove the thorn out and four hours later my finger throbbing. Cartilaginous articular erosion was noted, 1952 46 OLENGINSKI, BUSH, DC, HARRINGTON, TM knowledge no case...

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