The Experts below are selected from a list of 3963 Experts worldwide ranked by ideXlab platform
Esperanza Naredo - One of the best experts on this subject based on the ideXlab platform.
-
intramuscular versus ultrasound guided intratenosynovial glucocorticoid injection for Tenosynovitis in patients with rheumatoid arthritis a randomised double blind controlled study
Annals of the Rheumatic Diseases, 2017Co-Authors: Mads Ammitzbolldanielsen, Mikkel Ostergaard, Viktoria Fana, Daniel Glinatsi, Uffe Moller Dohn, Lykke Midtboll Ornbjerg, Esperanza NaredoAbstract:Objective The aim of this study was to compare the efficacy of intramuscular versus ultrasound (US)-guided intratenosynovial glucocorticoid injection in providing disease control after 2, 4 and 12 weeks in patients with rheumatoid arthritis(RA) with Tenosynovitis. Methods Fifty patients with RA and Tenosynovitis were randomised into two double-blind groups: (A) ‘intramuscular group’, receiving intramuscular injection of betamethasone and US-guided intratenosynovial isotonic saline injection and (B) ‘intratenosynovial group’ receiving saline intramuscularly and US-guided intratenosynovial betamethasone injection. All patients were in stable disease-modifying anti-rheumatic drug treatment prior to and during the study. Patients were excluded, and considered non-responders, if any treatments were altered during the follow-up period. ‘US Tenosynovitis remission’, defined as US Tenosynovitis grey-scale score ≤1 and colour Doppler score=0, was assessed at week 4 (primary outcome), and weeks 2 and 12, using non-responder imputation for missing data. Results US Tenosynovitis remission at week 4 was achieved in 25% (6/24) in the ‘intramuscular group’ versus 64% (16/25) in the ‘intratenosynovial group’, that is, a difference of −39 percentage point (pp) (CI −65pp to −13pp), Fisher exact test p=0.001. Corresponding values for the ‘intramuscular group’ versus the ‘intratenosynovial group’ at 2 and 12 weeks were 21% (5/24) versus 48% (13/25), that is, a difference of −27pp (CI −53pp to −2pp), p=0.072 and 8% (2/24) versus 44% (11/25), that is, difference of −36pp (−58pp to −13pp), p=0.003. Most US, clinical and patient-reported scores improved more in the ‘intratenosynovial group’ at all follow-up visits. Conclusions In this randomised double-blind clinical trial, patients with RA and Tenosynovitis responded significantly better to US-guided intratenosynovial glucocorticoid injection than to intramuscular glucocorticoid injection, both at 4 and 12 weeks follow-up. Trial registration number EudraCT nr: 2013-003486-34.
-
Reliability of a consensus-based ultrasound score for Tenosynovitis in rheumatoid arthritis
'BMJ', 2013Co-Authors: Esperanza Naredo, Annamaria Iagnocco, Emilio Filippucci, M.a. D'agostino, R.j. Wakefield, I. Moller, P.v. Balint, Z. Karim, L. Terslev, D.a. BongAbstract:Objective To produce consensus-based scoring systems for ultrasound (US) Tenosynovitis and to assess the intraobserver and interobserver reliability of these scoring systems in rheumatoid arthritis (RA). Methods We undertook a Delphi process on US-defined Tenosynovitis and US scoring system of Tenosynovitis in RA among 35 rheumatologists, experts in musculoskeletal US (MSUS), from 16 countries. Then, we assessed the intraobserver and interobserver reliability of US in scoring Tenosynovitis on B-mode and with a power Doppler (PD) technique. Ten patients with RA with symptoms in the hands or feet were recruited. Ten rheumatologists expert in MSUS blindly, independently and consecutively scored for Tenosynovitis in B-mode and PD mode three wrist extensor compartments, two finger flexor tendons and two ankle tendons of each patient in two rounds in a blinded fashion. Intraobserver reliability was assessed by Cohen's . Interobserver reliability was assessed by Light's . Weighted coefficients with absolute weighting were computed for B-mode and PD signal. Results Four-grade semiquantitative scoring systems were agreed upon for scoring Tenosynovitis in B-mode and for scoring pathological peritendinous Doppler signal within the synovial sheath. The intraobserver reliability for Tenosynovitis scoring on B-mode and PD mode was good ( value 0.72 for B-mode; value 0.78 for PD mode). Interobserver reliability assessment showed good values for PD Tenosynovitis scoring (first round, 0.64; second round, 0.65) and moderate values for B-mode Tenosynovitis scoring (first round, 0.47; second round, 0.45). Conclusions US appears to be a reproducible tool for evaluating and monitoring Tenosynovitis in RA
-
a systematic literature review of us definitions scoring systems and validity according to the omeract filter for tendon lesion in ra and other inflammatory joint diseases
Rheumatology, 2012Co-Authors: Maria Alcalde, Maria Antonietta Dagostino, George Arthur Willem Bruyn, Annamaria Iagnocco, Ingrid Moller, Richard J. Wakefield, Esperanza NaredoAbstract:Objective. To present the published data concerning the US assessment of tendon lesions as well as the US metric properties investigated in inflammatory arthritis. Methods. A systematic literature search of PubMed, Embase and the Cochrane Library was performed. Selection criteria were original articles in the English language reporting US, Doppler, Tenosynovitis and other tendon lesions in patients with RA and other inflammatory arthritis. Data extraction focused on the definition and quantification of US-detected Tenosynovitis and other tendon abnormalities and the metric properties of US according to the OMERACT filter for evaluating the above tendon lesions. Results. Thirty-three of 192 identified articles were included in the review. Most articles were case series (42%) or casecontrol (33%) studies describing hand and/or foot Tenosynovitis in RA patients. The majority of older articles used only B-mode, whereas the most recent studies have incorporated Doppler mode. Definition of Tenosynovitis or other tendon lesion was provided in 70% of the evaluated studies. Most of the studies (61%) used a binary score for evaluating tendon abnormalities. Concerning the OMERACT filter, 24 (73%) articles dealt with construct validity. The comparator most commonly used was clinical assessment and MRI. There were few studies assessing criterion validity. Some studies evaluated reliability (36%), responsiveness (21%) and feasibility (12%).
-
a systematic literature review of us definitions scoring systems and validity according to the omeract filter for tendon lesion in ra and other inflammatory joint diseases
Rheumatology, 2012Co-Authors: Maria Alcalde, Maria Antonietta Dagostino, George Arthur Willem Bruyn, Annamaria Iagnocco, Ingrid Moller, Richard J. Wakefield, Esperanza NaredoAbstract:Objective. To present the published data concerning the US assessment of tendon lesions as well as the US metric properties investigated in inflammatory arthritis. Methods. A systematic literature search of PubMed, Embase and the Cochrane Library was performed. Selection criteria were original articles in the English language reporting US, Doppler, Tenosynovitis and other tendon lesions in patients with RA and other inflammatory arthritis. Data extraction focused on the definition and quantification of US-detected Tenosynovitis and other tendon abnormalities and the metric properties of US according to the OMERACT filter for evaluating the above tendon lesions. Results. Thirty-three of 192 identified articles were included in the review. Most articles were case series (42%) or casecontrol (33%) studies describing hand and/or foot Tenosynovitis in RA patients. The majority of older articles used only B-mode, whereas the most recent studies have incorporated Doppler mode. Definition of Tenosynovitis or other tendon lesion was provided in 70% of the evaluated studies. Most of the studies (61%) used a binary score for evaluating tendon abnormalities. Concerning the OMERACT filter, 24 (73%) articles dealt with construct validity. The comparator most commonly used was clinical assessment and MRI. There were few studies assessing criterion validity. Some studies evaluated reliability (36%), responsiveness (21%) and feasibility (12%).
Kevin C Chung - One of the best experts on this subject based on the ideXlab platform.
-
attritional extensor tendon rupture in a patient with phialophora verrucosa Tenosynovitis case report
Hand, 2015Co-Authors: Michael Sorkin, Theodore A Kung, Kevin C ChungAbstract:Deep tissue fungal infections of the hand are exceedingly uncommon. We present a case of fungal Tenosynovitis caused by Phialophora verrucosa that led to extensor tendon rupture in a patient who was on chronic immunosuppressive therapy. Indolent fungal cysts can elude clinical diagnosis until excision is performed with definitive pathologic examination. In immunocompromised patients, antifungal therapy may be warranted after cyst excision even in the absence of acute infection to prevent subsequent progression to Tenosynovitis.
-
a systematic review of the management of acute pyogenic flexor Tenosynovitis
Journal of Hand Surgery (European Volume), 2015Co-Authors: Aviram M Giladi, Sunitha Malay, Kevin C ChungAbstract:Pyogenic flexor Tenosynovitis (PFT) is an aggressive closed-space infection that can result in severe morbidity. Although surgical treatment of pyogenic flexor Tenosynovitis has been widely described, the role of antibiotic therapy is inadequately understood. We conducted a literature review of studies reporting on acute pyogenic flexor Tenosynovitis management. A total of 28 case series articles were obtained, all of which used surgical intervention with varied use of antibiotics. Inconsistencies among the studies limited summative statistical analysis. Our results showed that use of antibiotics as a component of therapy resulted in improved range of motion outcomes (54% excellent vs. 14% excellent), as did using catheter irrigation rather than open washout (71% excellent vs. 26% excellent). These studies showed benefits of early treatment of pyogenic flexor Tenosynovitis and of systemic antibiotic use. As broad-spectrum antibiotics have changed the management of other infectious conditions, we must more...
-
flexor Tenosynovitis in the hand caused by mycobacterium terrae
Annals of Plastic Surgery, 1999Co-Authors: Joseph Fodero, Kevin C Chung, Vladimir M OgnenovskiAbstract:The authors describe an uncommon case of flexor Tenosynovitis caused by Mycobacterium terrae, an atypical mycobacterium generally considered nonpathogenic in humans. A prolonged delay in diagnosis and various ineffective therapies led to synovial biopsy and culture. After confirming the diagnosis of M. terrae, appropriate antimycobacterial chemotherapy resolved the synovitis. For chronic Tenosynovitis without a clear etiology, limited synovectomy and culture are essential in establishing a diagnosis and in initiating treatment for this atypical mycobacterial infection.
Tun Hing Lui - One of the best experts on this subject based on the ideXlab platform.
-
Endoscopic Synovectomy of Peroneal Tendon Sheath
'Elsevier BV', 2017Co-Authors: Tun Hing LuiAbstract:Peroneal Tenosynovitis usually responds to conservative therapy. Early diagnosis and management are imperative because improper or delayed diagnosis and treatment of peroneal Tenosynovitis may lead to progression of the Tenosynovitis to peroneal tendon rupture, ultimately limiting the benefit of nonoperative treatment. For refractory cases, endoscopic tenosynovectomy is indicated. The purpose of this Technical Note is to report a minimally invasive approach to perform a synovectomy of zones 1 and 2 of the peroneal tendon sheath
-
dorsalis pedis psuedoaneurysm a complication followed extensor tendoscopy of the ankle in a non tuberculosis patient with Tenosynovitis with rice body formation
Foot and Ankle Surgery, 2016Co-Authors: Tun Hing LuiAbstract:Tenosynovitis with rice body formation is very rare in the ankle region. A case of this condition in a non-tuberculosis patient was presented. He was treated by extensor tendoscopy of the ankle. The Tenosynovitis subsided after the procedure. However, it was complicated by formation of a dorsalis pedis pseudoaneurysm.
-
role of toe flexor tendoscopy in management of an unusual cause of metatarsalgia
Knee Surgery Sports Traumatology Arthroscopy, 2006Co-Authors: Tun Hing Lui, Hung Tsan ChowAbstract:The purpose of this study is to describe an endoscopic approach to toe flexor tendons at the level of metatarsal head region. And this study is a kind of retrospective case series. Three patients with toe flexor Tenosynovitis were evaluated after a follow-up of 2 years after toe flexor tendoscopy. One patient suffered from infective toe flexor tendosynovitis resulting from a penetrating injury and other two patients suffered from idiopathic focal toe flexor Tenosynovitis. Pre-operative metatarsalgia subsided after toe flexor tendoscopy. No endoscopy-related complication was observed. Toe flexor tendoscopy can be an effective operative means in the management of focal toe flexor Tenosynovitis.
Primadhi Andri - One of the best experts on this subject based on the ideXlab platform.
-
Efek Injeksi Plasma Kaya Platelet Terhadap Tenosinovitis Tendon Tibialis Posterior: Sebuah Studi Kasus
Fakultas Kedokteran. Universitas Katolik Widya Mandala Surabaya, 2019Co-Authors: Handoyo, Henry Ricardo, Bakri, Andryan Hanafi, Primadhi AndriAbstract:Introduction: Posterior tibial tendon dysfunction is one of the most common, problems of the foot and ankle. Tenosynovitis of the posterior tibial tendon (PTT) is an often unrecognized form of PTT dysfunction. Case: A 54-year-old woman presented with left ankle pain that began while morning walk three days prior. She noted that the left ankle hurt with even light touch and the pain was unrelieved with sodium diclofenac. She denied any history of trauma. She was seen in the outpatient clinic for this condition. On examination, a three centimeter area of pain was found posterior to the medial malleolus and parallel to the PTT. She also had a stage I flat foot and mild soft tissue swelling around medial malleolus region on her radiograph examination. Ultrasound examination was done with the result of anechoic fluid visible in the peritendinous space around the PTT. The patient received diagnosis of PTT Tenosynovitis, with the foot and ankle disability index (FADI) score was 58.7. Platelet rich plasma (PRP) injection was done twice with an interlude of two weeks. The pain subsided and the following FADI score was 84.6. Outcome: Patient showed improvement in her left ankle PTT Tenosynovitis after two PRP injection. Conclusion: This case report highlights the efficacy of PRP as a modality in managing PTT Tenosynovitis. Keywords: Ankle, Flat Foot, Posterior Tibial Tendon, Tenosynovitis, Platelet Rich Plasma
-
Efek Injeksi Plasma Kaya Platelet Terhadap Tenosinovitis Tendon Tibialis Posterior: Sebuah Studi Kasus
'Universitas Katolik Widya Mandala Surabaya', 2019Co-Authors: Handoyo, Henry Ricardo, Bakri, Andryan Hanafi, Primadhi AndriAbstract:Introduction: Posterior tibial tendon dysfunction is one of the most common, problems of the foot and ankle. Tenosynovitis of the posterior tibial tendon (PTT) is an often unrecognized form of PTT dysfunction. Case: A 54-year-old woman presented with left ankle pain that began while morning walk three days prior. She noted that the left ankle hurt with even light touch and the pain was unrelieved with sodium diclofenac. She denied any history of trauma. She was seen in the outpatient clinic for this condition. On examination, a three centimeter area of pain was found posterior to the medial malleolus and parallel to the PTT. She also had a stage I flat foot and mild soft tissue swelling around medial malleolus region on her radiograph examination. Ultrasound examination was done with the result of anechoic fluid visible in the peritendinous space around the PTT. The patient received diagnosis of PTT Tenosynovitis, with the foot and ankle disability index (FADI) score was 58.7. Platelet rich plasma (PRP) injection was done twice with an interlude of two weeks. The pain subsided and the following FADI score was 84.6. Outcome: Patient showed improvement in her left ankle PTT Tenosynovitis after two PRP injection. Conclusion: This case report highlights the efficacy of PRP as a modality in managing PTT Tenosynovitis
Annette H M Van Der Helmvan Mil - One of the best experts on this subject based on the ideXlab platform.
-
do musculoskeletal ultrasound and magnetic resonance imaging identify synovitis and Tenosynovitis at the same joints and tendons a comparative study in early inflammatory arthritis and clinically suspect arthralgia
Arthritis Research & Therapy, 2019Co-Authors: S Ohrndorf, Aleid C Boer, Debbie M Boeters, Robin Ten M Brinck, Gerdr Burmester, Marion C Kortekaas, Annette H M Van Der Helmvan MilAbstract:Ultrasound (US) and magnetic resonance imaging (MRI) are recommended in the diagnostic process of rheumatoid arthritis. Research on its comparability in early disease phases is scarce. Therefore, we compared synovitis and Tenosynovitis detected by US and MRI on joint/tendon level. Eight hundred forty joints and 700 tendons of 70 consecutive patients, presenting with inflammatory arthritis or clinically suspect arthralgia, underwent US and MRI of MCP (2–5), wrist and MTP (1–5) joints at the same day. Greyscale (GS) and power Doppler (PD) synovitis were scored according to the modified Szkudlarek method (combining synovial effusion and hypertrophy) and the recently published EULAR-OMERACT method (synovial hypertrophy regardless of the presence of effusion) on static images. US-detected Tenosynovitis was scored according to the OMERACT. MRI scans were scored according to the RAMRIS. Test characteristics were calculated on joint/tendon level with MRI as reference. Cut-off for US scores were ≥ 1 and ≥ 2 and for MRI ≥ 1. Compared to MRI, GS synovitis according to EULAR-OMERACT (cut-off ≥ 1) had a sensitivity ranging from 29 to 75% for the different joint locations; specificity ranged from 80 to 98%. For the modified Szkudlarek method, the sensitivity was 68–91% and specificity 52–71%. PD synovitis had a sensitivity of 30–54% and specificity 97–99% compared to MRI. The sensitivity to detect GS Tenosynovitis was 50–78% and the specificity 80–94%. For PD Tenosynovitis, the sensitivity was 19–58% and specificity 98–100%. Current data showed that US is less sensitive than MRI in the early detection of synovitis and Tenosynovitis, but resulted in only few non-specific findings. The higher sensitivity of MRI is at the expense of less accessibility and higher costs.
