Document Detail

Sea urchin spine arthritis of the hand.
MedLine Citation:
PMID:  18343297     Owner:  NLM     Status:  MEDLINE    
PURPOSE: Although rare, hand injury caused by puncture with the sea urchin spine can result in serious complications. To emphasize its clinical significance, this article describes a group of patients who sustained chronic granulomatous arthritis induced by puncture with sea urchin spine (designated sea urchin spine arthritis). METHODS: Five patients who developed sea urchin spine arthritis of the hand after puncture with sea urchin spine were treated at our hospitals. All lesions involved the proximal interphalangeal (PIP) joint (4 index fingers and 1 middle finger). Patients experienced pain, swelling, and discomfort around the site of puncture immediately after the injury. These initial symptoms subsided within a few days, and secondary symptoms including fusiform swelling, limited motion, and mild pain of the PIP joint appeared from 1 to 2 months later. Laboratory tests of inflammation and blood cell counts were negative. Plain radiographs showed soft tissue swelling and osteolysis but no visible spine. Thorough synovectomy of the PIP joint was performed, and the granulation tissue around the joint was also removed. RESULTS: No microorganism was identified from tissue culture or polymerase chain reaction in any of the 5 patients. At a mean follow-up of 21 months, 2 patients exhibited essentially normal active motion of the affected PIP joint, whereas the remaining 3 patients had diminished range of motion. CONCLUSIONS: Diagnosis of sea urchin spine arthritis can be made by history of sea urchin spine injury, a symptom-free period before the development of synovitis, and the absence of laboratory test abnormalities. Neither antibiotics nor nonsteroidal anti-inflammatory agents are effective. Undertaken early enough, thorough synovectomy might avoid complications and obtain favorable results. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.
Takuro Wada; Tamotsu Soma; Keiko Gaman; Masamichi Usui; Toshihiko Yamashita
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of hand surgery     Volume:  33     ISSN:  0363-5023     ISO Abbreviation:  J Hand Surg Am     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-03-17     Completed Date:  2008-06-17     Revised Date:  2009-06-08    
Medline Journal Info:
Nlm Unique ID:  7609631     Medline TA:  J Hand Surg Am     Country:  United States    
Other Details:
Languages:  eng     Pagination:  398-401     Citation Subset:  IM    
Department of Orthopaedic Surgery, Sapporo Medical University, Sapporo, Japan.
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MeSH Terms
Arthritis / physiopathology*,  radiography,  surgery
Finger Injuries / physiopathology*,  radiography,  surgery
Finger Joint / physiopathology*,  radiography,  surgery
Follow-Up Studies
Granuloma / pathology,  surgery
Middle Aged
Osteolysis / physiopathology,  radiography,  surgery
Radius / transplantation
Range of Motion, Articular / physiology
Retrospective Studies
Sea Urchins
Synovial Membrane / surgery
Synovitis / physiopathology,  surgery
Wounds, Stab / physiopathology*,  surgery

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