Dataset Information

Extensor Tendoscopy of the Wrist.

ABSTRACT: Extensor tenosynovitis of the wrist can lead to rupture of the extensor tendons. Extensor tenosynovectomy is indicated if the tenosynovitis cannot be controlled by conservative measures. Open tenosynovectomy requires extensive dissection of soft tissue, including the extensor retinaculum. This article describes extensor tendoscopy of the wrist. This technique allows approach to the extensor compartments with small incisions and minimal soft tissue dissection. It is indicated when extensor tenosynovitis persists despite adequate medical treatments including medications, immobilization, and steroid injection. Synovectomy of the extensor compartments can be performed with preservation of the extensor retinaculum. This technique is contraindicated if the wrist cannot be flexed or there is severe tendinopathy of the extensor tendon that may need open reconstruction. The purpose of this technical note was to describe a minimally invasive approach of complete synovectomy of the extensor compartments with preservation of the extensor compartment.

SUBMITTER: Lui TH

PROVIDER: S-EPMC5039733 | biostudies-literature | 2016 Aug

REPOSITORIES: biostudies-literature

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Extensor Tendoscopy of the Wrist.

Lui Tun Hing TH

Arthroscopy techniques 20160718 4

Extensor tenosynovitis of the wrist can lead to rupture of the extensor tendons. Extensor tenosynovectomy is indicated if the tenosynovitis cannot be controlled by conservative measures. Open tenosynovectomy requires extensive dissection of soft tissue, including the extensor retinaculum. This article describes extensor tendoscopy of the wrist. This technique allows approach to the extensor compartments with small incisions and minimal soft tissue dissection. It is indicated when extensor tenosy ...[more]

PMID: 27709032

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Project description:Background There is no international consensus on an optimal ultrasound score for monitoring of rheumatoid arthritis (RA) on patient-level yet. Our aim was to reassess the US7 score for the identification of the most frequently pathologic and responsive joint/tendon regions, to optimize it and contribute to an international consensus. Furthermore, we aimed to evaluate the impact of disease duration on the performance of the score. Methods RA patients were assessed at baseline and after 3 and 6 months of starting/changing DMARD therapy by the US7 score in greyscale (GS) and power Doppler (PD). The frequency of pathologic joint/tendon regions and their responsiveness to therapy were analyzed by Friedman test and Cochrane-Q test respectively, including the comparison of palmar vs. dorsal regions (chi-square test). The responsiveness of different reduced scores and the amount of information retained from the original US7 score were assessed by standardized response means (SRM)/linear regression. Analyses were also performed separately for early and established RA. Results A total of 435 patients (N = 138 early RA) were included (56.5 (SD 13.1) years old, 8.2 (9.1) years disease duration, 80% female). The dorsal wrist, palmar MCP2, extensor digitorum communis (EDC) and carpi ulnaris (ECU) tendons were most frequently affected by GS/PD synovitis/tenosynovitis (wrist: 45%/43%; MCP2: 35%/28%; EDC: 30%/11% and ECU: 25%/11%) and significantly changed within 6 months of therapy (all p ≤0.003 by GS/PD). The dorsal vs. palmar side of the wrist by GS/PD (p < 0.001) and the palmar side of the finger joints by PD (p < 0.001) were more frequently pathologic. The reduced US7 score (GS/PD: palmar MCP2, dorsal wrist, EDC and ECU, only PD: dorsal MCP2) showed therapy response (SRM 0.433) after 6 months and retained 76% of the full US7 score’s information. No major differences between the groups of early and established RA could be detected. Conclusions The wrist, MCP2, EDC, and ECU tendons were most frequently pathologic and responsive to therapy in both early and established RA and should therefore be included in a comprehensive score for monitoring RA patients on patient-level. Supplementary Information The online version contains supplementary material available at 10.1186/s13075-022-02874-y.

Dataset Information

Extensor Tendoscopy of the Wrist.

Publications

Extensor Tendoscopy of the Wrist.

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