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Vagy J. Clinical management of finger joint capsulitis/synovitis in a rock climber. Front Sports Act Living 2023; 5:1185653. [PMID: 37325798 PMCID: PMC10266264 DOI: 10.3389/fspor.2023.1185653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 04/14/2023] [Indexed: 06/17/2023] Open
Abstract
This case study presents a 23-year-old male recreational rock climber, who climbed an average of 3-4 times per week and presented with finger joint capsulitis/synovitis after increasing his climbing intensity and training from moderate to high over 6 months, which led up to injury. During the exam, the diagnosis was ruled in with clinical orthopedic testing. Additional movement analyses revealed improper gripping mechanics contributing to asymmetric finger loading. A comprehensive rehabilitation program was developed based on the concept of a progressive framework that included unloading of the affected tissues, increasing mobility, improving muscle performance, and correcting suboptimal climbing movements. After 6 weeks, the climber's pain 24 h after climbing, which was rated on a visual analog pain scale (VAS), decreased from 5.5/10 to 1.5/10 and 0/10 at the 12-month follow-up. His patient-specific functional scale improved from 0% at the initial evaluation to 43% after 6 weeks and to 98% after 12 months. His sports-specific disabilities of the arm, shoulder, and hand improved from 69% to 34% to 6% during the initial evaluation, 6-week follow-up, and 12-month discharge. He made a full recovery to his previous grade of V8 bouldering. This is the first case study of its kind to provide a rehabilitation framework for the management of finger joint capsulitis/synovitis in a rock climber.
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Ogura T, Hirata A, Hayashi N, Takenaka S, Ito H, Mizushina K, Fujisawa Y, Imamura M, Yamashita N, Nakahashi S, Kujime R, Kameda H. Comparison of ultrasonographic joint and tendon findings in hands between early, treatment-naïve patients with systemic lupus erythematosus and rheumatoid arthritis. Lupus 2016; 26:707-714. [PMID: 27837198 DOI: 10.1177/0961203316676375] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Although both systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) may lead to joint deformity, SLE arthritis is typically non-erosive and often accompanied by Jaccoud's deformity. Therefore, we examined characteristics of joint and tendon lesions in patients with SLE and RA by ultrasonography. Fifteen treatment-naïve SLE patients and 40 treatment-naïve RA patients with joint symptoms were included in this study. The hand joints and related tendons were ultrasonographically examined using grey-scale (GS) and power Doppler (PD). Joint involvement was comparably observed in patients with SLE and RA (80% versus 95%, p = 0.119). However, tendon involvement was more frequent in SLE than in RA (93% versus 65%, p = 0.045), especially in the wrist joints (73% versus 40%, p = 0.037). When we investigated the intensity of US findings, the joint synovitis score (GS + PD) per affected joint was lower in SLE than RA (2.0 versus 2.6, p = 0.019), while tendon inflammation score was not significantly different (2.1 versus 2.2, p = 0.738). Finally, the examination of concordance between joint and tendon involvement in the same finger revealed that joint lesion appeared in only 49% of fingers having tendon involvement in the SLE group, which was significantly less than 74% in the RA group ( p = 0.010). Thus, as compared with RA, SLE arthropathy is characterized by the predominance of tenosynovitis/periextensor tendon inflammation, which is likely to develop independently from joint synovitis.
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Affiliation(s)
- T Ogura
- Division of Rheumatology, Department of Internal Medicine, Toho University Ohashi Medical Center, Tokyo, Japan
| | - A Hirata
- Division of Rheumatology, Department of Internal Medicine, Toho University Ohashi Medical Center, Tokyo, Japan
| | - N Hayashi
- Division of Rheumatology, Department of Internal Medicine, Toho University Ohashi Medical Center, Tokyo, Japan
| | - S Takenaka
- Division of Rheumatology, Department of Internal Medicine, Toho University Ohashi Medical Center, Tokyo, Japan
| | - H Ito
- Division of Rheumatology, Department of Internal Medicine, Toho University Ohashi Medical Center, Tokyo, Japan
| | - K Mizushina
- Division of Rheumatology, Department of Internal Medicine, Toho University Ohashi Medical Center, Tokyo, Japan
| | - Y Fujisawa
- Division of Rheumatology, Department of Internal Medicine, Toho University Ohashi Medical Center, Tokyo, Japan
| | - M Imamura
- Division of Rheumatology, Department of Internal Medicine, Toho University Ohashi Medical Center, Tokyo, Japan
| | - N Yamashita
- Division of Rheumatology, Department of Internal Medicine, Toho University Ohashi Medical Center, Tokyo, Japan
| | - S Nakahashi
- Division of Rheumatology, Department of Internal Medicine, Toho University Ohashi Medical Center, Tokyo, Japan
| | - R Kujime
- Division of Rheumatology, Department of Internal Medicine, Toho University Ohashi Medical Center, Tokyo, Japan
| | - H Kameda
- Division of Rheumatology, Department of Internal Medicine, Toho University Ohashi Medical Center, Tokyo, Japan
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