Multiple Finger Extensor Tendon Dislocations in Systemic Lup
Dislocation of extensor tendons is the most frequently seen complaint for suffers of rheumatoid arthritis. Here, we present a rare clinical case of multiple finger extensor tendon dislocations in systemic lupus erythematosus (SLE). Upon physical examination, active extension of middle, ring and little fingers were impossible at the MP joint. A trigger phenomenon was generated when these extensors were reduced in passive extension. The procedure was performed under local anesthesia. A satisfactory clinical outcome was achieved with sagittal band reconstruction and reinforcement for the site using juncturae tendinum. Surgical intervention under the local anesthesia allowed for extensive gathering of information about repair site strength and dynamic stability.
Case Presentation
The patient is a 54-year-old female with a longstanding treatment history of SLE who suffers from difficulty in extending middle, ring and little fingers of the right hand actively at the MP joint.She noticed the swelling and tenderness on the dorsal aspect of the middle finger at the MP joint 10 months prior to presentation. Similar symptoms gradually progressed to ring and little fingers. She denied a history of trauma on the MP joint. The patient is on long-term Prednisolone therapy (more than 20 years) and was prescribed 15 mg per day on first visit to our hospital.Upon physical examination, those extensor digitorum communis (EDC) tendons demonstrated the ulnar deviation in flexion and reduction by passive extension with snapping (trigger phenomenon).Radiography revealed no abnormalities including joint collapse or dislocation.