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Root KT, Wright JO, Mandato N, Stewart BD, Moser MW. Subacromial-Subdeltoid Bursitis With Rice Bodies After Rotator Cuff Repair With a Collagen Scaffold Implant: A Case Report. JBJS Case Connect 2023; 13:01709767-202303000-00025. [PMID: 36735809 DOI: 10.2106/jbjs.cc.22.00565] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 11/30/2022] [Indexed: 02/05/2023]
Abstract
CASE We report the second-known case of subacromial-subdeltoid bursitis with rice bodies after rotator cuff repair with a Smith + Nephew REGENETEN bovine-derived bioinductive collagen scaffold implant. After the removal of rice bodies and a portion of implant that had not incorporated, the patient recovered well and made a full return to work and recreational activities. CONCLUSION This case demonstrates that persistent pain, swelling, or decreased range of motion for several months after rotator cuff repair with the use of a collagen implant may warrant a relatively early magnetic resonance imaging to evaluate for underlying pathology. It also provides a framework for physicians who may see similar patients in the future.
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Affiliation(s)
- Kevin T Root
- College of Medicine, University of Florida, Gainesville, Florida
| | - Jonathan O Wright
- Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, Florida
| | | | - Brian D Stewart
- Department of Pathology, Immunology and Laboratory Medicine, University of Florida, Gainesville, Florida
| | - Michael W Moser
- Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, Florida
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2
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Tian Y, Zhou HB, Yi K, Wang KJ. Idiopathic tenosynovitis of the wrist with multiple rice bodies: A case report and review of literature. World J Clin Cases 2022; 10:11908-11920. [PMID: 36405290 PMCID: PMC9669876 DOI: 10.12998/wjcc.v10.i32.11908] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 09/19/2022] [Accepted: 10/19/2022] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Multiple rice bodies in the wrist is a rare disorder that requires surgery, and there are still many uncertainties regarding its diagnosis and treatment.
CASE SUMMARY We described a rare case of chronic idiopathic tenosynovitis with rice bodies of the wrist in a 71-year-old man and reviewed similar topics in the literature. A total of 43 articles and 61 cases were included in the literature review. Our case had a usual presentation: it was similar to those in the literature. The affected population was mainly older adults, with an average age of 59.43 (range, 3 to 90) years. The male-to-female ratio was 1.54:1 (37/24).Most of them showed limited swelling and pain, only 23.0% had carpal tunnel symptoms, and the average disease duration was 18.03 (0.5-60) mo. Wrist flexor tendon sheath involvement was the most common (95.1%, 58/61), and only 3 cases had extensor tendon sheath involvement.The main causes were tuberculosis (34.4%, 21/61), non-tuberculous mycobacteria (24.6%, 15/61), idiopathic tenosynovitis (31.1%, 19/61), and others (9.84%, 6/61). There were 10 patients with recurrences; in 6 of them, were due to non-tuberculous mycobacterial infections.
CONCLUSION We reported a case of wrist idiopathic tenosynovitis with rice body formation, and established a clinical management algorithm for wrist tenosynovitis with rice bodies, which can provide some reference for our clinical diagnosis and treatment. The symptoms of rice-body bursitis of the wrist are insidious, nonspecific, and difficult to identify. The aetiology is mainly idiopathic tenosynovitis and mycobacterial (tuberculosis or non-tuberculous) infections; the latter are difficult to treat and require long-duration systemic combination antibiotic therapies. Therefore, before a diagnosis of idiopathic tenosynovitis is made, we must exclude other causes, especially mycobacterial infections.
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Affiliation(s)
- Yong Tian
- Department of Orthopedics, Yichang Yiling Hospital, Yichang 443100, Hubei Province, China
| | - Hong-Bin Zhou
- Department of Orthopedics, Yichang Yiling Hospital, Yichang 443100, Hubei Province, China
| | - Kai Yi
- Department of Orthopedics, Yichang Yiling Hospital, Yichang 443100, Hubei Province, China
| | - Kai-Jian Wang
- Department of Orthopedics, Yichang Yiling Hospital, Yichang 443100, Hubei Province, China
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Jeon CH, Kim TW, Park JY, Hwang CS, Lim S. Mycobacterium intracellulare Tenosynovitis with Rice Body Formation with Literature Review. Infect Chemother 2022:54.e61. [DOI: 10.3947/ic.2022.0025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 05/11/2022] [Indexed: 11/24/2022] Open
Affiliation(s)
- Cheon Hoo Jeon
- Division of Infectious Diseases, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Tae Woo Kim
- Department of Orthopedic Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Joon Young Park
- Department of Pathology, School of Medicine, Pusan National University, Yangsan, Korea
| | - Chung Su Hwang
- Department of Pathology, School of Medicine, Pusan National University, Yangsan, Korea
| | - Seungjin Lim
- Division of Infectious Diseases, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
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Turner NA, Sweeney MI, Xet-Mull AM, Storm J, Mithani SK, Jones DB, Miles JJ, Tobin DM, Stout JE. A Cluster of Nontuberculous Mycobacterial Tenosynovitis Following Hurricane Relief Efforts. Clin Infect Dis 2021; 72:e931-e937. [PMID: 33136139 DOI: 10.1093/cid/ciaa1665] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 10/26/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Nontuberculous mycobacteria (NTM) are a rare cause of infectious tenosynovitis of the upper extremity. Using molecular methods, clinical microbiology laboratories are increasingly reporting identification down to the species level. Improved methods for speciation are revealing new insights into the clinical and epidemiologic features of rare NTM infections. METHODS We encountered 3 cases of epidemiologically linked upper extremity NTM tenosynovitis associated with exposure to hurricane-damaged wood. We conducted whole-genome sequencing to assess isolate relatedness followed by a literature review of NTM infections that involved the upper extremity. RESULTS Despite shared epidemiologic risk, the cases were caused by 3 distinct organisms. Two cases were rare infections caused by closely related but distinct species within the Mycobacterium terrae complex that could not be differentiated by traditional methods. The third case was caused by Mycobacterium intracellulare. An updated literature review that focused on research that used modern molecular speciation methods found that several species within the M. terrae complex are increasingly reported as a cause of upper extremity tenosynovitis, often in association with environmental exposures. CONCLUSIONS These cases illustrate the importance of molecular methods for speciating phenotypically similar NTM, as well as the limitations of laboratory-based surveillance in detecting point-source outbreaks when the source is environmental and may involve multiple organisms.
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Affiliation(s)
- Nicholas A Turner
- Department of Medicine, Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina, USA
| | - Mollie I Sweeney
- Department of Molecular Genetics and Microbiology, Duke University School of Medicine, Durham, North Carolina, USA
| | - Ana M Xet-Mull
- Department of Molecular Genetics and Microbiology, Duke University School of Medicine, Durham, North Carolina, USA
| | | | - Suhail K Mithani
- Department of Surgery, Division of Plastic, Oral and Maxillofacial Surgery, Duke University School of Medicine, Durham, North Carolina, USA
| | - David B Jones
- Orthopedic Institute, Sioux Falls, South Dakota, USA
| | | | - David M Tobin
- Department of Molecular Genetics and Microbiology, Duke University School of Medicine, Durham, North Carolina, USA
| | - Jason E Stout
- Department of Medicine, Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina, USA
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Kaji Y, Nakamura O, Yamaguchi K, Nomura Y, Oka K, Yamamoto T. Combined administration of rifampicin, ethambutol, and clarithromycin for the treatment of tenosynovitis of the hand caused by Mycobacterium avium complex: Case series and literature review. Medicine (Baltimore) 2021; 100:e25283. [PMID: 33907090 PMCID: PMC8084042 DOI: 10.1097/md.0000000000025283] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 03/06/2021] [Accepted: 03/08/2021] [Indexed: 12/04/2022] Open
Abstract
ABSTRACT We report the clinical results and problems of combined administration of rifampicin, ethambutol, and clarithromycin (REC) for the treatment of Mycobacterium avium complex (MAC) infection of the hand (hand MAC).Participants included 7 patients with hand MAC. After resection of the infected lesion, REC was prescribed for 12 months. For these patients, the site of infection, clinical course after initiation of REC, adverse drug effects (ADEs), and incidence of recurrence were evaluated.Sites of infection were the flexor tenosynovium in 5 patients, extensor tenosynovium in 1 patient, and both flexor and extensor tenosynovium in 1 patient. ADEs of REC occurred in 5 patients, and included visual disturbance caused by ethambutol in 2 patients, liver function abnormality caused by rifampicin in 2 patients, and fever with diarrhea caused by rifampicin in 1 patient. For 2 of these 5 patients, desensitization therapy was applied and REC was able to be reinstated. In the remaining 3 patients, the causative drugs were discontinued and levofloxacin, a new quinolone, was administered. Complete healing was achieved in 5 patients, and recurrence was observed in 2 patients. These 2 patients with recurrence included 1 patient in whom REC was completed and 1 patient in whom REC therapy was modified due to ADE.REC provided relatively good clinical results as a treatment for hand MAC. However, recurrences were observed even after the completion of REC and the use of an alternative drug. Optimal duration of REC and appropriate alternative drugs need to be identified in the future.
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Affiliation(s)
- Yoshio Kaji
- Department of Orthopaedic Surgery, Kagawa University Faculty of Medicine
- Department of Rehabilitation Medicine, Kagawa University Hospital, Kagawa, Japan
| | - Osamu Nakamura
- Department of Orthopaedic Surgery, Kagawa University Faculty of Medicine
| | - Konosuke Yamaguchi
- Department of Orthopaedic Surgery, Kagawa University Faculty of Medicine
| | - Yumi Nomura
- Department of Orthopaedic Surgery, Kagawa University Faculty of Medicine
| | - Kunihiko Oka
- Department of Orthopaedic Surgery, Kagawa University Faculty of Medicine
| | - Tetsuji Yamamoto
- Department of Orthopaedic Surgery, Kagawa University Faculty of Medicine
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Horseshoe abscess of the hand with rice bodies secondary to mycobacterium avium intracellulare infection. Clin Imaging 2020; 63:24-29. [PMID: 32120309 DOI: 10.1016/j.clinimag.2020.02.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Revised: 02/04/2020] [Accepted: 02/25/2020] [Indexed: 01/01/2023]
Abstract
A horseshoe abscess is caused by infection that spreads between the flexor tendon sheath of the thumb or little finger through the radial and ulnar bursae through communication between the two and/or the space of Parona. We present a case of an 80-year-old woman with rheumatoid arthritis who presented with 6 months of right hand and wrist soft tissue swelling, initially treated as a rheumatoid arthritis flare. MRI demonstrates the horseshoe abscess and after surgical irrigation and debridement with synovectomy, cultures demonstrated infection with mycobacterium avium intracellulare (MAI). This case demonstrates the importance of MRI in diagnosing and evaluating the extent of hand infections and for considering mycobacterial organisms for appropriate treatment and antibiotic regimen.
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Huayllani MT, Sisti A, Boczar D, Restrepo DJ, Parker AS, Sarabia-Estrada R, Rinker BD, Forte AJ. Chronic Tenosynovitis of the Upper Extremities Caused by Mycobacterium kansasii : A Clinical Case and Systematic Review of Literature. Indian J Plast Surg 2020; 53:25-35. [PMID: 32367915 PMCID: PMC7192657 DOI: 10.1055/s-0040-1709377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background Chronic tenosynovitis of the upper extremities caused by Mycobacterium kansasii ( M. kansasii ) is uncommon, but symptoms may overlap with other more common diseases. Late diagnosis and treatment can lead to disfiguration of structures and rupture of tendons, resulting in worse cosmetic outcomes after reconstruction. Methods We present a clinical case and literature review of M. kansasii in patients with chronic tenosynovitis of upper extremities. PubMed was queried for cases of upper extremities tenosynovitis caused by M. kansasii . The keywords " M. kansasii ," "tenosynovitis" and synonyms were used for search in different combinations. Manuscripts, with no specific data or another condition, where the infection was not located in the upper extremities, were reviews, or not in English, were excluded from the study. Results We described 23 reported cases of tenosynovitis of the upper extremity caused by M. kansasii . An immunosuppressed state was present in eight (34.8%) cases, and 12 (52.2%) patients received immunosuppressive treatment. A long-time period between the first appearance of symptoms and the definitive diagnosis was identified (median: 7 months, interquartile range: 9). The most frequent symptoms were local swelling (65.2%), pain (56.5%), mass effect (26%), and stiffness (13%). Tendon rupture was found in three (13%) patients as a complication of the disease. Moreover, seven (30.4%) patients underwent previous surgeries to try to relieve the symptoms before definitive diagnosis was achieved. Conclusion M. kansasii is an important differential causal pathogen for tenosynovitis of the upper extremities. Although rare, raising awareness about this infectious disease is imperative to avoid inadequate management and hazardous aesthetic sequelae.
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Affiliation(s)
- Maria T. Huayllani
- Division of Plastic Surgery, Mayo Clinic, Jacksonville, Florida, United States
| | - Andrea Sisti
- Division of Plastic Surgery, Mayo Clinic, Jacksonville, Florida, United States
| | - Daniel Boczar
- Division of Plastic Surgery, Mayo Clinic, Jacksonville, Florida, United States
| | - David J. Restrepo
- Division of Plastic Surgery, Mayo Clinic, Jacksonville, Florida, United States
| | - Alexander S. Parker
- University of Florida, College of Medicine, Jacksonville, Florida, United States
| | | | - Brian D. Rinker
- Division of Plastic Surgery, Mayo Clinic, Jacksonville, Florida, United States
| | - Antonio Jorge Forte
- Division of Plastic Surgery, Mayo Clinic, Jacksonville, Florida, United States
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Vail KJ, Stranahan LW, Richardson LM, Yanchik AE, Arnold CE, Porter BF, Wiener DJ. Granulomatous Rhinitis in a Horse due to Mycobacterium intracellulare Infection. J Comp Pathol 2019; 169:30-34. [PMID: 31159948 DOI: 10.1016/j.jcpa.2019.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 03/27/2019] [Accepted: 04/02/2019] [Indexed: 10/26/2022]
Abstract
Mycobacterial infections in horses are uncommon, but are caused most frequently by Mycobacterium bovis of the Mycobacterium tuberculosis complex or Mycobacterium avium of the M. avium complex. Disease caused by Mycobacterium intracellulare, the second most common species within the M. avium complex, has not been reported in horses to date. Mycobacteriosis in horses most often presents as enteric, pulmonary or, rarely, systemic disease. Here we report a case of M. intracellulare infection in a horse presenting as a granulomatous nasal mass.
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Affiliation(s)
- K J Vail
- Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA.
| | - L W Stranahan
- Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - L M Richardson
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - A E Yanchik
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - C E Arnold
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - B F Porter
- Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - D J Wiener
- Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
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