scholarly journals Effect of Methotrexate in the Treatment of Distal Interphalangeal Joint Extensor Tendon Enthesopathy in Patients with Nail Psoriasis

2018 ◽  
Vol 7 (12) ◽  
pp. 546 ◽  
Author(s):  
Magdalena Krajewska-Włodarczyk ◽  
Agnieszka Owczarczyk-Saczonek ◽  
Waldemar Placek ◽  
Maja Wojtkiewicz ◽  
Joanna Wojtkiewicz
Keyword(s):  
Nail Plate ◽  
Extensor Tendon ◽  
Interphalangeal Joint ◽  
Response To Treatment ◽  
Distal Interphalangeal Joint ◽  
Nail Psoriasis ◽  
The Matrix ◽  
Tendon Thickness ◽  
Distal Interphalangeal ◽  
Methotrexate Treatment

To assess the effect of methotrexate on the development of distal interphalangeal joint extensor tendon enthesopathy in psoriasis, thirty-two people aged 34 to 57 years with nail psoriasis and distal interphalangeal joint extensor tendon enthesopathy (19 patients with Ps (psoriasis) and 13 with PsA (psoriatic arthritis) were started on methotrexate at 15 to 25 mg/week and the treatment was continued for 6 months). A total of 319 nails were examined. After six months of treatment, the thicknesses of the nail plate, nail bed and nail matrix were found to decrease in both groups of patients. Methotrexate treatment resulted in a decrease in the joint extensor tendon thickness only in patients with Ps (0.94 ± 0.05 vs. 0.96 ± 0.04, p < 0.001), where the tendon thickness after treatment correlated with the matrix thickness (r = 0.337, p = 0.018) and with the bed thickness (r = 0.299, p = 0.039). Methotrexate treatment resulted in a decrease in the extensor tendon thickness only in patients with Ps but not in PsA. The findings of this study may suggest the effectiveness of systemic treatment of nail psoriasis in patients without arthritis and the use of US nail examinations in Ps and PsA patients in morphological change assessment and response to treatment.

scholarly journals Distal interphalangeal joint extensor tendon enthesopathy in patients with nail psoriasis

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Magdalena Krajewska-Włodarczyk ◽  
Agnieszka Owczarczyk-Saczonek ◽  
Waldemar Placek ◽  
Maja Wojtkiewicz ◽  
Andrzej Wiktorowicz ◽  
...  
Keyword(s):  
Extensor Tendon ◽  
Interphalangeal Joint ◽  
Distal Interphalangeal Joint ◽  
Nail Psoriasis ◽  
Distal Interphalangeal

scholarly journals Ultrasound Evaluation of the Effectiveness of the Use of Acitretin in the Treatment of Nail Psoriasis

2021 ◽  
Vol 10 (10) ◽  
pp. 2122
Author(s):  
Magdalena Krajewska-Włodarczyk ◽  
Zbigniew Żuber ◽  
Agnieszka Owczarczyk-Saczonek
Keyword(s):  
Morphological Changes ◽  
Nail Plate ◽  
Clinical Signs ◽  
Extensor Tendon ◽  
Control Group ◽  
Nail Bed ◽  
Nail Psoriasis ◽  
Ultrasound Evaluation ◽  
Tendon Thickness ◽  
Retinoid Treatment

The study aimed to evaluate the effect of retinoid treatment on the morphological changes in the nail apparatus in patients with nail psoriasis. Material and methods: 41 patients aged 32 to 64 with nail psoriasis, without clinical signs of psoriatic arthritis, started on acitretin 0.6 to 0.8 mg kg b.w./d, for six months and 28 people in the control group were included in the study. Both groups had ultrasound examination of fingernails and digital extensor tendon in the distal interphalangeal joints. In psoriatic patients, US examination was conducted before starting the treatment and after six months. A total of 685 nails were examined. Results: After six months of treatment, there was a reduction in the thickness of the nail bed and nail matrix (p = 0.046 and p = 0.031, respectively). The thickness of the nail plates decreased, although it was statistically insignificant (p = 0.059) and it was higher than in the control group (p = 0.034). The reduced severity of clinical nail changes after six months of retinoid treatment did not correlate with the reduction in extensor tendon thickness in any group of patients. Conclusions: In patients with nail psoriasis, acitretin treatment resulted in a rapid decrease in the thickness of the nail bed and matrix, but it did not affect the thickness of the nail plate after six months. There was no effect of acitretin on the digital extensor tendon thickness or the increased blood supply to the tendon area. The results of the study may indicate the usefulness of ultrasound nail examinations in patients with nail psoriasis not only to assess the advancement of morphological changes and response to treatment, but also to choose the potential treatment.

scholarly journals Broken Kirschner Wire in Distal Interphalangeal Joint Fixation: A Case Report

2021 ◽  
Vol 26 (3) ◽  
pp. 171-173
Author(s):  
Kyung Jin Lee ◽  
Jung Hyun Park ◽  
Sung Hoon Koh ◽  
Dong Chul Lee ◽  
Si Young Roh ◽  
...  
Keyword(s):  
Kirschner Wire ◽  
Extensor Tendon ◽  
Interphalangeal Joint ◽  
Middle Phalanx ◽  
Distal Interphalangeal Joint ◽  
Protective Measures ◽  
X Ray ◽  
Distal Interphalangeal ◽  
Continued Use

Kirschner wire (K-wire) has been widely used for treatment of fracture for its cost-effectiveness and reliability. This case presents the K-wire breakage in distal interphalangeal joint (DIPJ) fixation. A 55-year-old male patient was injured by a knife and showed rupture of extensor tendon at 1/2 of middle phalanx. A 0.9-mm K-wire was implemented for DIPJ extension, and tenorrhaphy was done. After 6 weeks, we detected breakage of K-wire in the follow-up X-ray. The broken K-wire in the distal phalanx was removed. We removed the remaining K-wire through an incision on volar side of middle phalanx under C-arm after 2 weeks for the patient’s personal reasons. Breakage during postoperative K-wire maintenance is exceedingly rare. This patient is presumed to have ruptured because he continued using his finger. Therefore, while K-wire is present, continued use of finger without protection may cause breakage, so protective measures such as splint are required.

Osteophyte excision without cyst excision for a mucous cyst of the finger

2013 ◽  
Vol 39 (3) ◽  
pp. 258-261 ◽  
Author(s):  
H.-J. Lee ◽  
P.-T. Kim ◽  
I.-H. Jeon ◽  
H.-S. Kyung ◽  
I.-H. Ra ◽  
...  
Keyword(s):  
Medical Records ◽  
Lateral Collateral Ligament ◽  
Extensor Tendon ◽  
Skin Incision ◽  
Interphalangeal Joint ◽  
Distal Interphalangeal Joint ◽  
Cyst Excision ◽  
Post Operative Pain ◽  
Distal Interphalangeal ◽  
Mucous Cyst

Osteophyte excision is a mainstay of treatment for mucous cyst combined with Heberden’s node in a distal interphalangeal joint or in an interphalangeal joint of the thumb. The aim of this study was to evaluate the results of osteophyte excision without cyst excision for the treatment of a mucous cyst combined with Heberden’s node. The medical records of 37 patients (42 cases) with a mucous cyst with Heberden’s node were retrospectively reviewed. Thirty-eight of 40 cases with available pre-operative simple radiographs showed evidence of joint arthrosis. A T-shaped skin incision of the joint capsule between the extensor tendon and lateral collateral ligament was used. Osteophyte excision without cyst excision was performed. All cysts, except one, regressed without recurrence or a skin complication after osteophyte excision, but eight cases showed post-operative pain and loss of range of motion. Osteophyte excision without cyst excision may be a good treatment choice for mucous cyst of the finger.

Is the involvement of the distal interphalangeal joint in psoriatic patients related to nail psoriasis?

2004 ◽  
Vol 23 (1) ◽  
pp. 27-30 ◽  
Author(s):  
Raffaele Scarpa ◽  
Francesco Manguso ◽  
Alfonso Oriente ◽  
Rosario Peluso ◽  
Mariangela Atteno ◽  
...  
Keyword(s):  
Interphalangeal Joint ◽  
Distal Interphalangeal Joint ◽  
Nail Psoriasis ◽  
Distal Interphalangeal

K-Wire Fixation for Extraarticular Transverse/Short Oblique Fractures of the Shaft of the Middle Phalanx Associated with Extensor Tendon Injury

2008 ◽  
Vol 33 (5) ◽  
pp. 561-565 ◽  
Author(s):  
M. M. AL-QATTAN
Keyword(s):  
Extensor Tendon ◽  
Tendon Injury ◽  
Interphalangeal Joint ◽  
Middle Phalanx ◽  
Distal Interphalangeal Joint ◽  
Active Motion ◽  
Total Active Motion ◽  
Distal Interphalangeal ◽  
A Prospective Study

In a prospective study, 22 cases of extraarticular transverse/short oblique fractures of the shaft of the middle phalanx associated with extensor tendon injury had fixation of the fracture as well as immobilisation of the distal interphalangeal joint using a K-wire. Mobilisation of the proximal interphalangeal and metacarpophalangeal joints was started immediately after surgery. The wires were removed after 6 weeks. No post-operative complications were noted. At final follow-up (mean = 15 weeks, range = 12–24 weeks), 18 of 22 patients obtained excellent and good total active motion (TAM) scores. Stiffness was confined to the distal interphalangeal joint, and hence when the results were re-analysed for motion at that joint only, only 11 patients had excellent and good outcomes.

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