Tajika Tsuyoshi, Saito Kenichi, Tomomatsu Yusuke, Kuboi Takuro, Hatori Yuhei, Hirato Junko, Yanagawa Takashi, Chikuda Hirotaka
Graduate School of Health Sciences, Gunma University, Maebashi, Japan.
Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan.
SAGE Open Med Case Rep. 2022 Apr 25;10:2050313X221095703. doi: 10.1177/2050313X221095703. eCollection 2022.
Flexor tenosynovitis is rare in young children. This case report describes that of a 10-year-old boy with diffuse swelling of the left index finger, pain when catching a ball, and progressive inability for full flexing of the finger 2 months after starting baseball play. Magnetic resonance imaging showed a defined lesion with iso-signal intensity to muscle on T1-weighted imaging, and with high signal intensity to muscle on T2-weighted imaging. It was enhanced in T1-weighted fat suppression imaging with gadolinium enhancement. Surgical excision relieved the symptom. Histopathological findings mainly indicated proliferation of synoviocytes and plasma cell and lymphocyte infiltration. We speculated that the physical impact of the ball on the left index finger of his gloved hand during catching activated some immunological mechanism and thereby caused nonspecific tenosynovitis in this young baseball player. Awareness of this pathophysiology might raise confidence in proper diagnosis for assessing the swelling of fingers in young baseball players.
屈指腱鞘炎在幼儿中较为罕见。本病例报告描述了一名10岁男孩，其左手食指弥漫性肿胀，接球时疼痛，在开始打棒球2个月后手指逐渐无法完全弯曲。磁共振成像显示在T1加权成像上有一个与肌肉等信号强度的明确病变，在T2加权成像上相对于肌肉呈高信号强度。在钆增强的T1加权脂肪抑制成像中病变有强化。手术切除缓解了症状。组织病理学结果主要显示滑膜细胞增生以及浆细胞和淋巴细胞浸润。我们推测，接球过程中球对手戴手套的左手食指的物理冲击激活了一些免疫机制，从而导致这位年轻棒球运动员发生非特异性腱鞘炎。了解这种病理生理学可能会增强对年轻棒球运动员手指肿胀进行正确诊断评估的信心。
