Arch Hand Microsurg.  2020 Jun;25(2):118-123. 10.12790/ahm.20.0010.

Painful Pseudotendon Caused by Closed Rupture of the Flexor Carpi Radialis Tendon: A Case Report and Literature Review

• Roh YT
• Jeong C
• Lee J
• Hwang S
• Park IJ

• KMID: 2502707
• DOI: http://doi.org/10.12790/ahm.20.0010

Abstract

Closed rupture of the flexor carpi radialis tendon in non-rheumatoid patients is uncommon. We report a case of a 53-year-old woman who developed painful pseudotendon after a complete rupture of the flexor carpi radialis tendon due to osteoarthritis of the scaphotrapezial trapezoidal joint.

Keyword

Flexor carpi radialis tendon; Scaphotrapezial trapezoidal joint; Closed rupture; Pseudotendon

Figure

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  Fig. 1. The clinical photograph showed no flexor carpi radialis (FCR) tendon was observed on the left wrist. PL, palmaris longus tendon.

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  Fig. 2. Plain radiographs and computed tomography (CT) images. The posteroanterior (A) and oblique (B) view of the left wrist showed arthritic change at the scaphotrapezial trapezoidal (STT) joint. (C, D, E) CT images showed the osteophytes produced by STT joint osteoarthritis protruded into the drive path of the flexor carpi radialis tendon.

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  Fig. 3. Magnetic resonance imaging findings. The axial (A), coronal (B) and sagittal (C) sections demonstrated a complete rupture and proximal retraction of FCR tendon (white arrows). The second sagittal image (D) showed the distal segment of FCR tendon is visible near the insertion site (white arrowhead). And the last sagittal image (E) revealed severe osteoarthritis involving the scaphotrapezial trapezoidal joint with irregular projecting osteophytes (white star). FCR, flexor carpi radialis.

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  Fig. 4. Intraoperative photographs. (A, B) Thickening of FCR tendon and the pseudotendon formation in the distal portion were noted. (C) Resected FCR tendon and pseudotendon. The normal tendon was on the left side (white arrow) and the pseudotendon on the right side (black arrow). (D) Distal scaphoid excision was performed to treat osteoarthritis of scaphotrapezial trapezoidal joint. FCR, flexor carpi radialis.

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  Fig. 5. Photomicrography of normal tendon (A) and the pseudotendon (B). The pseudotendon had decreased cell distribution, irregular collagen fiber and less dense collagen bundle compared with the normal tendon (H&E ×100).

Reference

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